BerrowLot_ApplicationForm

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					STANDING ORDER MANDATE
(Do not send to your bank)
Please complete details of your bank
                                                          Inkberrow Football Club:
                                                          Inkberrow Football Club was established in its current form in
                                                          1978. The junior section was established in 2000 and in 2005
Bank;…………………………………………………
                                                          the junior and senior sections combined. The club now provides
                                                          football to over 200 children and adults.
Address:………………………………………………
                                                          The Objects of Inkberrow Football Club are
…………………………………………………………                                    1. To provide an opportunity for boys, girls, men and women
                                                             from Inkberrow and surrounding area to participate in soccer
Post Code:…………………                                            matches, soccer coaching and social activities.
                                                          2. To be a Club that is renowned for:-
Sort Code:………………                                               o The development of individual and team skill through
                                                                 high quality and qualified coaching
                                                               o The promotion of high standards of behaviour through
Account No:……………………………………………                                     the promotion of Codes of Conduct that would befit a
                                                                 club committed to the principles of FA Charter Standard
Account Name:……………………………………….                                  o A style of play that promotes a high level of technical skill
                                                               o A competitive spirit and the will to win as a team
Please Pay:   National Westminster Bank plc                    o The cooperation, support and encouragement that exists
                                                                 within all individuals and all teams for each other
For the credit of: ‘Inkberrow FC’                                throughout the Club
                                                               o Welcoming all players irrespective of their ability, gender,
                                                                 race, nationality, ethnicity, colour, religion or sexual
Sort Code: 51-70-32. Account No: 91311713
                                                                 orientation
                                                               o Fun and enjoyment; a hub of the community for the
The sum of (*delete/complete as appropriate)                     community and a Club that contributes positively to
                                                                 village life.
*£2.50 (two pounds fifty pence) on 1st of each calendar
         month
*£7.50 (seven pounds fifty pence) each quarter [1st of
         February, May, August, November each year]
                                                          Any enquiries regarding Berrowlot should be directed to
                                                          the co-ordinator (address below) or:
                                                                The Secretary, Inkberrow FC,
                                                                                                                                  BERROWLOT
Using Ref:
…………………………………………………………                                    Inkberrow FC Committee reserve the right to refuse any
(surname+membershipnumber will be inserted)               application.                                                             THE OFFICIAL LOTTERY OF
Payments to commence *………………………………                                                                                               INKBERROW FOOTBALL CLUB
                                                              Berrowlot Co-ordinator, Orchard Rise, Mill Lane,
Signature:………………………………………………                                     Radford, Nr Inkberrow. Worcs WR7 4LP.
                                                                           Tel: 01386 792683.
Date:……………………………………………………                                          Email: berrowlot@inkberrowfc.co.uk
                                                                          www.inkberrowfc.co.uk
       `

       Draft V1.0: 04.08
What is Berrowlot?                                                                                                                Berrowlot
                                           Entry Fees:                                                                        APPLICATION FORM
BerrowLot was launched in 2008 to
                                           Entry fees for the lottery are £30 per year.                        Title:……..       First Name:………………………………..
raise funds to support the ongoing
running and development costs              These can be paid annually, quarterly or                            Surname:……………………………………………………….
associated with all sections of            monthly. Annual payments are required by
                                           cheque, and quarterly and monthly                                   Address:………………………………………………………..
Inkberrow Football Club. BerrowLot
                                           payments by standing order only (£7.50                              …………………………………………………………………..
provides you with the opportunity to
                                           february may, august, november or £2.50
support Inkberrow Football Club and                                                                            Postcode:………….……………………………………………
                                           each calendar month)
enter a lottery draw to win cash prizes.
                                                                                                               Tel No:…………………………………………………………..
How does Berrowlot work?                   How to enter                                                        Email:……………………………………………………………

Annual membership of the Lottery is
open to anyone aged 16 years or over.
                                           Please complete the application form
                                           opposite and submit with your cheque for
                                                                                                               I am 16 years of age or over…………….              
Unique membership numbers are              £30 (or completed standing order form
issued for each annual membership          overleaf). The Berrowlot co-ordinator or any                        I enclose a cheque for £30                      
purchased. This unique number will be      Inkberrow FC committee member will be                                                            OR
entered into the quarterly draws           pleased to receive your application.
                                                                                                               Completed Standing Order Mandate overleaf       
The following prizes will be awarded       You will be notified of your unique number
quarterly   (March,    June,   Sept,       and the date of the next quarterly draw.
December each year).
          First Prize:     £50
          Second Prize:    £15                   Thank you for your support
          Third Prize      £10

The quarterly draws will be conducted        Data Protection:
                                             The Data Controller of the personal data you provide is the
by Inkberrow FC Committee at its             Committee of Inkberrow FC. We take you privacy                    Send completed application form to, or request further
regular meetings or at public events.        seriously and have taken steps to protect it. Except where        information from Berrowlot Co-ordinator – address given
                                             we are compelled to do so by law, we will not share your          overleaf
Winners will be notified by the Co-          details with any other third party for any purpose and your
ordinator and all winnings paid by           data will only be used for the purpose of administering
                                             your membership of Berrowlot and occasionally to keep
cheque as soon as possible after the         you up to date with activities via email or post.
draw.


     Draft V1.0: 04.08

				
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