Add chances to your Lottery membership

Please use the form below to add chances to your existing Lottery membership.

We wish you the best of luck with your Lottery numbers in future draws and hope that we can count on your loyal support for many years to come.

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Date
MM slash DD slash YYYY
Lottery Membership Number*
Title*
First name*
Surname*
Post code*
Email*
How many chances would you like to add to your membership?*
Declaration*
- I agree that my existing direct debit amount will be amended according to the additional chance I would like added to my membership, as indicated above.
St Nicholas Hospice (Suffolk) is licensed and regulated in Great Britain by the Gambling Commission, under account number 5004.
Protecting your data
St Nicholas Hospice Care will only ever use your data in relevant and meaningful ways to you.
You can learn more about data protection and change your preferences at www.stnicholashospice.org.uk/yourdata or by calling our Fundraising team on 01284 766133.
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Protecting your data