Black and Amber 200 Club Sign Up
Please provide the below information to join the Black and Amber 200 Club
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Email *
Name *
Postal Address *
Phone number *
How will you be paying each month? If you have set up more than one £5 per month please let us know in the comments (eg Standing Order for £10 for two numbers etc) Payments need to be received by the 20th of the month *
Required
If you have set up a Standing Order by Online Banking what Reference Number have you provided (we suggest using your full name) *
Any other comments you think will be helpful (eg you have set a Standing Order up for £15 for three numbers each month)
A copy of your responses will be emailed to the address you provided.
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