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I would like to pay

  • for one entry per week for 10 weeks
  • for one entry per week for 25 weeks
  • for one entry per week for a year

Your Information

Name

Contact Details

About you

Terms and Conditions

   
* Please confirm you have read the Terms and Conditions (above)


* Which charity would you like your membership to support?


How did you hear about the Lottery?


* You must be 16 or over to play



Date of birth - We ask for this because you need to be over 16 to play the lottery


* make a smile lottery will contact you via post, email or telephone with regards to 'administering' your lottery membership. We would also love to contact you occasionally to let you know how your lottery membership is supporting the charity you have chosen to support. Can we contact you via (please tick)






* Do you give permission for the charity you are supporting to contact you with updates on the charity, fundraising events and newsletters via (please tick)






Is this a gift for somebody else?


Any other comments?


Are you renewing your existing membership?


Existing Membership Number


Payment Information

(?)