CONTACT DEATIALS

Your Name (required) - Applicants must be over 16 years of age

Your Email (required)

Telephone (required)

ADDRESS

Address 1 (required)

Address 2

Town or City (required)

County (required)

Postcode (required)

PAYMENT

We accept three types of payment, please select... Standing OrderChequeBank Transfer

Standing Order - Please create a standing order with your bank for the sum of £5 to be paid monthly to...
Bank: Barclays Bank - Weston-Super-Mare
Sort Code: 20-94-74
Account: 4379 8283

Cheque - Please send a cheque for £60 (12 months lottery entry) made payable to "Marlens Lottery" to the following address...
Marlen
Newton House
25 Hill Road
Clevedon
BS21 7NE

Bank Transfer - Please make a bank transfer of £60.00 (12 months lottery entry) to the following bank...
Bank: Barclays Bank - Weston-Super-Mare
Sort Code: 20-94-74
Account: 4379 8283

IMPORTANT - Your Payment Reference
So that we can identify your payments in our bank statement, please give a reference [initial][name][house number] for example JSMITH99

Chosen payment reference - (required) must follow the above format and match what you set up at the bank

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Consent to use personal information
By clicking send you are declaring that you have read the rules (click here) of the Marlens Lottery and that Marlens may store your data while you remain a member.

You will be allocated a number and entered into the draw when your payment is received.
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