Please complete and forward this section to your bank:

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Beneficiary: The Icelandic Horse Society

Bank Account: Lloyds Bank, Ringwood, Dorset

Sort Code: 30-97-08

Account Number: 01236932

Payment of £………………(amount in words)…………………………………………

From……..(Day)…………..(Month)…………(Year) annually until further notice.

Name of Account to be Debited………………………………………………………..

Sort Code…..-…..-…… Account Number………………………….

Signatures…………………………………………………………….

……………………………………………………………………….. Date:…………..

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Please complete and forward this section to The Secretary, IHSGB, 50 Locksley Close, New York, North Shields, Tyne & Wear, NE29 8EN.

I/We* wish to apply to become members/renew membership* (*delete where appropriate) of the IHSGB and have informed out bank to commence a standing order for £___ commencing on the date _________till further notice.

Signed:……………………………………………….Date:…………………………