LOTTERY MEMBERSHIP FORM
Please complete the form below.
I wish to apply for membership of the AIRDRIE UNITED F.C.
Lottery. I hereby authorise my bank/building society to make monthly/quarterly/half yearly/ in advance to maintain my
subscription of £1 per week for 52 weeks per year.
This authority is to remain until recalled by me in writing.
(Payments to be made by standing order from your account.)
MEMBERS DETAILS
Name ______________________________
Address ____________________________
Postcode ___________
Tel No. Home _____________________
Email _ _________________________________
BANK/BUILDING SOCIETY DETAILS
Name
Address
ACCOUNT DETAILS
ACCOUNT NO.
SORT CODE
Declaration
On the (date) of (month) and monthly/quarterly/ half
yearly thereafter, please pay to Royal
Bank of Scotland
Glasgow City Branch 10 Gordon St. Glasgow G1 3PL.
Airdrie United F.C.
Sort Code 83 07 06, Account No. 10159299
the sum of £4.33 / £13.00 / £26.00. Per entry.
Or multiples of these amount for more than one entry.
Signature
Date
