| Complete
the following application form for White Lodge Centre, Chertsey |
To
play, simply complete all 3 sections below and return your completed
form to:
The Weather Lottery Plc, FREEPOST NEA12220, LEEDS LS6 2YY.
Each
entry costs £1 a week – that's just 20p a day.
|
| 1.
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 |
|
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| Entry
2 |
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| Entry
3 |
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|
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 |
|
|
|
| 2.
Your Details |
Complete
your personal details and sign below.
| Name |
| Address |
| Postcode |
| Signature |
| |
| 3.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 |
| |
|