Stopsley Striders 100 Club 
An 11-month fundraiser for Brain Tumour Research (December 2022 - October 2023)
£1 per number per month so £11 for 11 months (please pay in full)
3 prizes a month, drawn on the closest club night to the end of the month
50% of that month's pot for prize money, 50% to the charity
1st prize - 25%, 2nd prize - 15%, 3rd prize - 10%
Details for Bank Transfer - HSBC, Kate Neale, 40-10-02, 11459821 (please add your name as a reference)
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Name *
Telephone number *
Date *
MM
/
DD
/
YYYY
Number(s) between 1-100 - first choice *
Numbers(s) between 1-100 - alternative choices *
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