Lottery Registration Form

Registration Form

RSPCA Cornwall Branch - Rescue Animal Lottery
Thank you for your interest in taking part in our Rescue Animal Lottery - you are about to do something amazing for animals in need in Cornwall!

Our Branch is a separately registered charity (no: 1024808) and are not funded by the RSPCA, so your contribution to our lottery will go towards helping us rescue, rehabilitate and rehome hundreds of animals every year. The money raised from our lottery stays with our Branch to directly support our work in Cornwall.

Please complete your details below. You are welcome to set up your own Standing order to the account details provided, or we can forward you a paper Standing order form to complete and return.

If you have any questions, please email lottery@rspcacornwall.org.uk
Your details
Full Name*

First NameLast Name
Address*

CityCounty

Postcode
E-mail
example@example.com
Lottery Number Information
Please indicate how many numbers per monthly draw you would like:
If you wish to take more than 5 numbers per month, please email lottery@rspcacornwall.org.uk
We will require a Standing Order for your lottery subscriptions please. You can either set this up yourself via your bank to pay into the account shown below, or request a Standing Order form which we can post out to you to complete and return. Please indicate below:

I will set up my own Standing order for £5.00 per lottery number per month to the bank details provided below.I would like a Standing order form sent to me in the post
If you wish to set up your own Standing Order via your bank for your lottery subscription, please use the follow details:

Account name: Royal Society for the Prevention of Cruelty to Animals Cornwall Branch

Account Number: 54337260 Sort Code: 30-98-76

Reference: Lottery

This is a business account
Do you consent to us adding you to our mailing contact list to receive newsletters and other information about the Branch?

YesNo
By submitting this form, you are confirming that you are over the age of 16 to legally participate in this lottery. Please see the Gambling Act 2005 or follow the link for further information:

Gambling Act 2005 (legislation.gov.uk)
Please tick to indicate that you understand that each number chosen will cost £1.25 per week, and therefore £5.00 per month*

Yes
Should be Empty:

Registration Form

Your details

Lottery Number Information

By submitting this form, you are confirming that you are over the age of 16 to legally participate in this lottery. Please see the Gambling Act 2005 or follow the link for further information: