Lottery Membership Signup

Hospice Lottery
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Membership Signup
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Please complete this form to apply for your membership.

Name

Address

Town

County

Postcode

Telephone Number

Email Address

Number of Memberships

Subscription Length

3 Months (£13.00)
6 Months (£26.00)
1 Year (£52.00)

Commencing immediately until further notice.

Amount

DATA PROTECTION: We would like to keep you informed about our fundraising and hospice activities. We will not disclose your details to any other organisation. Please tick this box if you would not like to receive further information.

Please click here to read the Lottery Rules (PDF).

Please click the Payment button to visit our secure online payment page

Your payment will appear on your bank statement as 'Weston Hospicecare Lottery'. If you have any queries please phone the Lottery Team on 01934 423923