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Application - Steeple Morden Primary Lottery Club 2021/2022
I would like to help raise funds by joining the Steeple Morden Primary School Lottery Club
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Email
*
Your email
Name of person completing this form
*
Your answer
How many numbers would you like to purchase at £12 each?
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1 number
2 numbers
3 numbers
4 numbers
Required
How much are you paying?
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£12 (payment for 1 number for the year)
£24 (payment for 2 numbers for the year)
£36 (payment for 3 numbers for the year)
£48 (payment for 4 numbers for the year)
How are you paying?
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BACS
https://docs.google.com/document/d/1wPyQ3O3WvdGU2m6Lm_0ZlHUxIhzK-xDAEbSL61g_7AM/edit?usp=sharing
Cheque sent in to school marked for PTA's attention
1st number full name (over 16s only. Winning cheques will be made out to this person)
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Your answer
2nd number full name (over 16s only. Winning cheques will be made out to this person)
Your answer
3rd number full name (over 16s only. Winning cheques will be made out to this person)
Your answer
For 4th number full name (over 16s only. Winning cheques will be made out to this person)
Your answer
Contact email address/es (so we can send lottery number & request bank details if you win)
*
Your answer
Contact phone number (will only be used if we can't reach you by email)
Your answer
I have read, understand and agree to the club rules:
https://docs.google.com/document/d/1ykdSk_Fn6NJtSvAAO9mLCXj2MwBTmkwZ5h7s9w8qC78/edit?usp=sharing
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Yes
No
Required
Date
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Your answer
A copy of your responses will be emailed to the address you provided.
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