Hassocks Amenity Association
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Hassocks Amenity Association Lottery Application
I /We would like to support the community groups involved in this Lottery and apply for membership in the 12 monthly draw series starting in
January 2016 and ends in December 2016.
By entering I understand that my lottery fee balances remaining after draws made, are fully refundable should the promoters determine that sales of numbers fall below a viable level and elect to close the lottery. I further understand and agree that by contributing to the Hassocks Village Lottery, Hassocks Amenity Association and Hassocks Community Partnership which includes Light Up Hassocks will benefit from the proceeds.
Following the special January prize draw subsequent draws will be allocated to a total of 40% of the funds raised each month. First prize will be 60% of this allocation and second prize 40%.
NB.
Please only use this form if you wish to pay using your bank's online banking service (we will register your application and send you our bank details by email for payment).
If you would prefer please click here to download the manual form
.
Name
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First
Last
Email
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Telephone
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Address
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Select tickets and price
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January 2016 - 1 tickets £12
January 2016 - 2 tickets £24
January 2016 - 3 tickets £36
January 2016 - 4 tickets £48
February 2016 - 1 ticket £11
February 2016 - 2 tickets £22
February 2016 - 3 tickets £33
February 2016 - 4 tickets £44
March 2016 - 1 ticket £10
March 2016 - 2 tickets £20
March 2016 - 3 tickets £30
March 2016 - 4 tickets £40
April 2016 - 1 ticket £9
April 2016- 2 tickets £18
April 2016 - 3 tickets £27
April 2016 - 4 tickets £36
May 2016 - 1 ticket £8
May 2016 - 2 tickets £16
May 2016 - 3 tickets £24
May 2016- 4 tickets £32
June 2016 - 1 ticket £7
June 2016 - 2 tickets £14
June2016 - 3 tickets £21
June 2016 - 4 tickets £28
Entry closed
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