Personal details

To set up your lottery play, please complete your details below. If you want to provide us with any additional details not covered by this form or if you want to pay by card for a set number of weeks only, please call the lottery office on 01543 434020. Thank you for your support.
Details
*Title
*First name
*Surname
*Contact number
Mobile number
*Date of birth. You must be over 18 to play the St Giles Hospice Lottery.
*Email address
*Confirm email
Address
Enter postcode and optionally house number in address line1 then click 'Find Address'
*Postcode
*Address line 1
*Town
County
*Where did you hear about our lottery?
Please Specify:

Data Protection: By completing your details you are giving consent for St Giles Hospice Lottery to use your data for administrative purposes related to running our weekly lottery. We value the support we receive from our local community and take the protection of your data very seriously. We will never pass your information to anyone outside the St Giles Hospice Group who isn’t directly working on our behalf, and we will keep your details safe and secure.

As a valued supporter, we will occasionally send you information about our work, events and activities by post based on our legitimate interest to do so - unless you tell us otherwise. Please select if you do not wish to receive information about St Giles by post.
We are also trying to reduce costs by communicating electronically with our supporters where appropriate. Please tell us if you are happy to receive information about our work, events and activities in the following ways:
Remember you can change your choices at any time by contacting us to let us know. Our full privacy statement is available at www.stgileshospice.com/privacy-statement or by calling 01543 432538.
Payment details
Bank details
St Giles Hospice Lottery
Fisherwick Road
Whittington
Lichfield
Staffordshire
WS14 9LH
DDLogo

Email: lott@stgileshospice.com

For any queries contact our Supporter Care Lottery Team on: 01543 434020

You will need your account details, which can be found on your cheque book or bank statement, to complete the direct debit instruction. Is the account in your name or, if in joint names, you are authorised to set up a direct debit as a single signatory? If the account requires multiple signatories, please call us on 01543 434020 and we will send you the appropriate form.