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Banker's Order Form for Payment
To___________________________________(Your Bank)
Address______________________________
_____________________________________
On receipt of this order, and thereafter on the first day of OCTOBER each year,
please pay BANK OF IRELAND, COLLEGE GREEN, DUBLIN 2 (NSC 900017) the sum specified below for the credit of the
IRISH ASSOCIATION OF LAW TEACHERS ACCOUNT No 53334610 and debit my account with yourselves accordingly.
This supercedes any previous order by me in favour of the Association.
Annual Amount:* _____
19.05(Ordinary membership) / 12.27(Associate rnembership) [*delete as appropriate]
FROM
ADDRESS ..
.
ACCOUNT No
SIGNED
DATE
Please return this banker's order form to your bank
FOR OFFICE USE ONLY
