Wufoo

Renewal Form

Name and Address of Organisation *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email *
Person to whom correspondence should be addressed and their position held *
Payment Type *
I will send a cheque payable to “The Lotteries Council” for £175 being the Annual Subscription Please send an invoice for £175 once our renewal has been approved

Please forward cheques to Judith Horner, 21 Bristow Close, Great Sankey, Warrington, WA5 8EU.
Ts & Cs *
In making this application I/we confirm we have read and agree to the 2 points at the top of this page
Do Not Fill This Out