Personal Details
Details
*Title
*First name
*Surname
*Contact no
Mobile no.
*Date of birth (players must be 18 or over)
*Email address
*Confirm email
Address
Enter postcode and optionally house number in address line1 then click 'Find Address'
*Postcode
*Address line 1
*Town
County
*How did you hear about us?
Please Specify:
We would like to send you information about our fundraising and events, and other ways in which you can help us. We will write to you by post unless you ask us not to. Please tell us if there are other ways you’d like to hear from us.
Please contact me via:
Payment Details
Bank Details
Community Hospice
185 Bostall Hill
London
SE2 0GB
DDLogo

Email: lottery@gbch.org.uk

For any queries contact our helpline: 020 8320 5785

Are you the only signatory required to authorise this direct debit? If not, please contact our helpline number above.