Lottery form

Sign up to our lottery

Personal Details

Title *

First Name *

Last Name *

Email *

Telephone

Where did you hear about us?

Your support helps provide extraordinary care to extraordinary children. We look forward to keeping in touch with you by post or phone with updates about our work.

Demelza respects your privacy and will process your details in accordance with UK and EU Data Privacy Regulations and will never sell or share your information. To learn more, please view our Privacy Policy. If you prefer not to receive updates by post or phone, please complete our opt-out form or contact us.

Communication Preferences

Yes, I'm happy to hear from you by email
Yes, I'm happy to hear from you by text and online

Your address

Postcode *

Address Line 1 *

Address Line 2

Town/City *

County *

Weekly draw

Superdraw

To enter the Superdraw you must be a current regular player of the Weekly Draw. (If you already pay for your Weekly Draw by direct debit please contact the Lottery team on 01795 845222).

I would like to play the Superdraw, and agree that this will incur an additional charge of £1.00 per chance

Number of chances

Total superdraw cost: £1.00

Payment Details

Direct Debit Details

Please provide your bank details for the Direct Debit:

Account Holder Name *

Sort Code *

Enter your 6-digit sort code without hyphens or spaces

Account Number *

Enter your 8-digit account number without hyphens or spaces

Collection Date *

Payment Frequency *

I confirm I wish to setup a Direct Debit.
*
In order to set up an online Direct Debit you must be the account holder of a personal bank or building society account and the sole required signatory on the account.
*

Payment Summary

Total Direct Debit Payment: £0.00

Please select a payment frequency

First payment date will be calculated after selection

Summary

Your Direct Debit:

Lottery Details:

Personal Details:

Account Details:

The company name which will appear on your bank statement against your direct debit will be: Demelza Trading Ltd.

To view our Direct Debit Guarantee, please click here

Postal address: Demelza Hospice Care for Children, Rook Lane, Sittingbourne, Kent, ME9 8DZ
Email: lottery@demelza.org.uk