Nicaragua Solidarity Campaign

Loteria Standing Order form
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To the Manager: (Write your bank/building society's name and address)

........................................................................................................


Account Name (Name of your bank account) ............................................................................

Account Number.............................................

Sort Code (Your bank sort code) ............/........./.........

Please pay Nicaragua Solidarity Campaign......£12.00 (Twelve Pounds)

every year starting on ........./........./.........(date) until further notice.

Signed....................................... Date................................................

Credit A/C of: Nicaragua Solidarity Campaign,

Unity Trust Bank, 4 The Square, 111 Broad St, Birmingham B15 1AR

Sort Code 08-60-01 Account no. 50724556

Return to NSC, 129 Seven Sisters Road, London N7 7QG Tel: 020 7272 9619 Email: nsc@nicaraguasc.org.uk