Melvin Gaels GAA
Lotto Annual Subscription Application Form & Membership
I _________________________________________________________ of
____________________________________________________________
____________________________________________________________
Tel No_______________________________________________________
Apply for membership of Melvin Gaels Club and Lotto draw. I agree to abide by the club rules.
Signed_______________________________________________________
Date ___/___/___
My 4 Lotto Numbers are as follows: (Please make your selection by placing an X on 4 boxes below)
The following format can be used for payment.
To:
Manager_________________________________________________Bank
Please deduct from my Bank Account.
Account Number:___________________________
Bank Sort Code: _____-_____-_____
By Standing order for €50 (fifty euro only), and credit to:
Melvin Gaels GAA Lotto Account
Account Number: 70348222
Sort Code: 93-71-85
At: AIB, Bundoran, Co. Donegal
Signed_______________________________________________________
Date ___/___/___