HELP THE ROBINS REVIVAL AND BE A WINNER TOO!
Simply complete the application form below and send it to:
Revival 50/50 Draw, STFC Supporters Club, County Ground, Swindon SN1 2ED
Yes, I would like to join the Robins Revival 50/50 Draw

Name ................................................................................................................................................

Address ............................................................................................................................................

Post Code ..................................................................... Telephone Number ...................................

PART A - Payment by Cash / Cheque

£6 - 6 games; £12 - 12 games; £24 - 24 games. Payment must be enclosed with application

SIGNED .......................................................................... DATE...............................................................

PART B - Payment by Standing Order

For 1 x £1.00 personal draw number please deduct my account as follows:

Your Bank's Name ..........................................................................................................................................

Your Bank's Address.......................................................................................................................................

Please pay to LLOYDS TSB SWINDON 309841 ..........................................................................................
For credit of STFC SUPPORTERS CLUB ROBINS REVIVAL DRAW 0312666 ...............................................

Please quote following Ref. No. On payment *Official use only* .....................................................................
Your Account Details

Account Name .......................................................................................................................................

Account Number ............................................................. Bank Sort Code...........................................

Your Name .............................................................................................................................................

Address .................................................................................................................................................

Post Code ..................................................................... Telephone Number .........................................

SIGNED .......................................................................... DATE................................................................