Paying your membership by Standing Order saves you and The Burma Campaign time and money.

You can spread the cost of membership over the year and don't have to worry about remembering to renew your membership every year.

It also helps us keep our costs down.

If you would prefer to use a standing order or cheque to donate to The Burma Campaign please print out this page and send the entire form to:

   The Burma Campaign UK - NOT to your Bank
   28 Charles Square
   London
   N1 6HT
   Tel: 020 7324 4710
   Fax: 020 7324 4717
   E.mail: info@burmacampaign.org.uk

Membership Rates:
   Family £25
   Single £15
   Concessions £8
   Overseas £20

Please accept my donation of: £250   £200   £100   £50   £20   Other £......

Cheques/POs payable to 'The Burma Campaign UK'

your details:
Name:		__________________________________________
Address:		__________________________________________
		__________________________________________
Post Code:		___________________
Tel:		___________________
Email:		___________________
to the manager:
Bank:		__________________________________________
Address:		__________________________________________
		__________________________________________
Post Code:		___________________
Sort Code:		___________________
Please pay The Burma Campaign UK the sum of:
		£ _________________
Every:		Month/Year (delete as appropriate)
(To allow for processing please start your Standing Order at least one month from today)
Starting on:		________________________________ Date
Debit my account no:		__________________________________________
Signature:		__________________________________________
Date:		__________________________________________
		Pay: The Burma Campaign UK, A/C 50095353, The Co-operative Bank, 1 Islington High St, London N1 9TR Sort Code 08-90-33.