The Great Weather Lottery Application Form
Complete the following application form for
The Bradford Cancer Support Lottery |
|
To play simply complete all 3 sections and return your completed form to us at
Lottery Service Providers Ltd, FREEPOST NEA12220, LEEDS LS6 2YY.
Each entry costs £1 a week - that's just 20p a day
|
| Choose Your Lucky Numbers |
Enter a single digit number (0-9 inclusive) in each box. Match 3 or more numbers in sequence to win.
| Location |
C |
I |
T |
I |
E |
S |
| Example |
3 |
4 |
0 |
0 |
5 |
1 |
| Entry 1 |
|
|
|
|
|
|
| Entry 2 |
|
|
|
|
|
|
| Entry 3 |
|
|
|
|
|
|
Tick one box below to show how many entries you wish to play. Each 6 number entry costs £4.34 for 1 month (equal to just 20p a day).
| Entries |
Cost for 1 month |
Tick Here |
| 1 |
£4.34 |
|
| 2 |
£8.68 |
|
| 3 |
£13.02 |
|
|
|
|
Your Details
|
Complete your personal details and sign below.
| Name |
| Address |
| Postcode |
| Signature |
|
|
|
How to Pay
(You can pay by Cheque or Postal Order, or you can pay by Bank Standing Order)
|
|
To pay by Cheque or Postal Order, make cheques payable to Prize Provision Services Ltd
£13 per line for 13 Weeks
£26 per line for 26 Weeks
£52 per line for 52 Weeks
|
To Pay by BANKERS STANDING ORDER, please complete the following:
| to the Manager of: |
| Bank |
| Address |
| Postcode |
|
Please pay Prize Provision Services Ltd A/C No. 22438844 Sort Code 40-27-15 the amount of:
| £4.34 |
£8.68 |
£13.02 |
Monthly |
|
|
| |
| My Account Name |
|
|
|
|
| Signature |
| Print Name |
| Start from (for office use only) |
| and thereafter until further notice quoting my membership number of |
| for office use only |
|
|
|