Harriet Davis Trust Lottery Application

Harriet Davis Trust Lottery Application

Thank you for joining our Small Society Lottery. It is important that you read the Terms and Conditions before signing up. Please complete the form below and read the payment options carefully. If you would like to pay annually or monthly by standing order and require more than one number, please let us know by emailing Susie at harrietdavistrust@gmail.com.
Please note, payment needs to be made by 18th of month or your number will not be entered into the draw. Please set up any monthly arrangements on or before the 18th of the month in time for the draw which will take place on 25th of the Month, excluding Christmas when we will draw on 20th. Any payment set up after 18th will be entered into the following month.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Payment Options

We have a number of payment options to join our lottery. You can choose to either pay a one off annual fee of £120 per number or set up a monthly standing order for £10 per number, per month using the bank details below. We have also created a subscription option for ease of monthly payments using your credit or debit card, although this does incur a nominal fee per transaction for the Trust.
Which payment option is your preference (whichever you tick will adjust the form below.)*

Monthly standing order set up by you from your bank accountAnnual payment as a bank transfer from your bank accountMonthly subscription using our easy payment platform
Annual Payments or Standing Orders
If you would prefer to pay annually by bank transfer or monthly by standing order, please set up your payment arrangement using the bank details below. It is very important that you reference your payment with your full name.

Please be aware that these bank details are different to the Trust's main bank account so you will need to set this account up as a new payee. We have created a separate account for the lottery for ease of accounting and it is really important that you don't set up your bank transfers or standing orders into our main account.
Bank Details

Name - The Harriet Davis Seaside Holiday Trust for Disabled Children

Sort Code - 30-63-59

Account Number - 34384168
Please let us know which date you plan to set up your standing order if that is your chosen payment method.

DayMonthYear
Date
Automatic Monthly Subscription

As the alternative to setting up your monthly payment by standing order, you can set up an automatic monthly subscription by clicking one of the options below and entering your credit or debit card details, your account will be automatically billed monthly on the date that you set this up; You can cancel your subscription at any time by contacting Susie at harrietdavistrust@gmail.com. Please note - this is a pay monthly subscription and not a way to make a one off annual payment.

HDT Lottery 1 NumberMonthly payment of £10 for one number in our fundraising lottery.

£10.00 for each month

HDT Lottery 2 NumbersMonthly payment of £20 for two numbers in our fundraising lottery.

£20.00 for each month

HDT Lottery 3 NumbersMonthly payment of £30 for three numbers in our fundraising lottery.

£30.00 for each month

Payment Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

You can cancel your subscription at any time by contacting Susie at harrietdavistrust@gmail.com. However, if you cancel before your payment has been processed for the current month, your number will not be entered into that month’s lottery draw.
Should be Empty:

Harriet Davis Trust Lottery Application

Payment Options

Annual Payments or Standing Orders

Automatic Monthly Subscription