24 Games  (Cost = £24)

12 Games  (Cost = £12)

6 Games    (Cost = £6) 

Payment by regular bankers order

Please complete this form and print. Only complete part 2, if you wish to pay by bank standing order. 

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

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

..........................................................................................................Post Code.........................

Telephone number.................................…..........E-mail address.......................................................................

Complete and send with payment, unless you are paying by standing order (UK currency only) to "Robins Revival 50/50 Draw, STFC Supporters Club, County Ground, Swindon SN1 2ED"Cheques- (payable to Robins revival draw).We will then advise you of your number that will go into each game's draw. This will remain the same throughout the season (Note: You MUST be aged at least 16 to enter)

(We will contact you again, before you reach the last game you have paid for)

Part 2 Robins Revival draw – bankers standing order.

Please insert the name address of your bank below

Bank ............................

Branch address including post code  ......................................................

................................................................................................

Please pay to:

 LloydsTsb Swindon 309841

 Account number  0312666 for the account of “The Robins revival draw”

The following amount as indicated by the ticked box.

£ 6 immediately and £6 quarterly thereafter until further notice

£24 immediately and £24 annually on the same date thereafter until further notice

Quoting reference number   __________  ( Will be completed by the Supporters Club)

Account name (print)................................   Account number .......................

Your Bank sort code.......................

Your Address: including post code

.............................................................................................

Signed...............................................   Date....................