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Mandate-Flyer Proof 005.Pdf Registered Charity No. 1106234 Welcome to Hampshire and Isle of Wight Air Ambulance Flight for Life Lottery Ordinary People. Extraordinary Care. Supported by You. Through your support, Hampshire and Isle of Wight Air Ambulance brings an advanced Critical Care Team to sick and injured people in Hampshire and the Isle of Wight when they need it most. Available both day and night, 365 days a year, the Air Ambulance Critical Care Team is called out many times a day to attend to road traffic collisions, sporting accidents, collapses and many other incidents. Highly skilled crews of doctors, paramedics and pilots can be at the scene of an incident within minutes, ready to deliver the same level of care that you would expect from a hospital emergency department. It currently costs in excess of £9,000 a day to maintain our life-saving service, and it is only thanks to the generosity of the communities that we serve that we are able keep the Air Ambulance flying and saving lives. By joining our weekly lottery, you are playing a vital role in helping us to raise the funds needed every day. On receipt of your application form, we will send you a welcome letter. The letter will contain your unique lottery numbers, more information on our lottery and a car sticker. The draw takes place every Friday and we send weekly winners their prize cheques through the post, so there is no need to claim. The draw results are available on our website www.hiowaa.org and are also published in some local newspapers. Please do not hesitate to call us on 02380 057 722 if you have any queries regarding your membership. Thank you once again for your support and good luck! Lottery Office Charity Head Office Cumulus House, Shortcut Way, 22 Oriana Way, Nursling, New Milton Southampton Hampshire BH25 6ED Hampshire SO16 0YU Telephone: 02380 057 722 Telephone: 02380 743 510 Lottery Information and Terms and Conditions of Ticket Sale Only persons over 16 years of age who are resident in Great Britain may play this lottery. A draw takes place every Friday until further notice (first draw 30th September 2005). The tickets are sold to you on the condition that you consent to your details being stored on our computer for the purposes of notifying prize winners. You may also receive correspondence from us unless you selected not to receive such correspondence on your application form. Each ticket contains six unique draw numbers. These numbers are entered into the weekly draw provided that the £1 entry fee has been paid. The draw is performed by a computer. All six numbers on each ticket are valid for each prize, except that, once a ticket has won a prize, the six numbers on that ticket are removed from the draw for the remainder of the prizes that week i.e. each ticket cannot win more than one prize each week. This lottery is promoted on behalf of Hampshire and Isle of Wight Air Ambulance and is registered with The Gambling Commission, www.gamblingcommission.gov.uk, Registration No. 000-004845- N-306385-009. Registered Charity No. 1106234. Promoter - Alex Lochrane, Hampshire and Isle of Wight Air Ambulance, 22 Oriana Way, Nursling, Southampton, Hampshire SO16 0YU Direct Debit Amount and Frequency Regular Cheque Joining Date:............................... Payment 1 Ticket 2 Tickets Joining Date: Monthly Monthly An initial payment of £6.34, An initial payment of £12.68, ................................. then £4.34 per month then £8.68 per month £13 Every 13 Weeks £26 Every 13 Weeks Cheque Amount: £26 Every 26 Weeks £52 Every 26 Weeks £52 Every 52 Weeks £104 Every 52 Weeks £............................... Monthly Direct Debits Only: The additional £2 per membership on your first monthly payment is applied to your ticket to ensure that it remains in credit. Without the extra initial payment, your ticket would run out of credit and drop out of the draw in certain weeks, due to there being more than four weeks in a month, and slightly more than fifty-two weeks in a year. Whilst it is extremely unlikely that this type of weekly Lottery draw will lead to excessive gambling, it is our duty as a Lottery operator to promote responsible gambling. If you have a gambling problem, then please call the National Gambling Help Line on 08088 020 133, www.begambleaware.org. For help with self-exclusion, please call our Lottery Office on02380 057722. The Direct Debit Guarantee • This Guarantee is offered by all Banks and Building Societies that accept instructions to pay Direct Debits. • If there are any changes to the amount, date or frequency of your Direct Debit, Hampshire and Isle of Wight Air Ambulance will notify you 10 working days in advance of your account being debited or as otherwise agreed. If you request Hampshire and Isle of Wight Air Ambulance to collect a payment, confirmation of the amount and date will be given to you at the time of the request. • If an error is made in the payment of your Direct Debit by Hampshire and Isle of Wight Air Ambulance or your Bank or Building Society you are entitled to a full and immediate refund of the amount paid from your Bank or Building Society. If you receive a refund you are not entitled to, you must pay it back when Hampshire and Isle of Wight Air Ambulance asks you to. • You can cancel a Direct Debit at any time by simply contacting your Bank or Building Society. Written confirmation may be required. Please also notify us. Note: If you choose to pay by Direct Debit you will receive a notification letter confirming your payment details, prior to the first payment being taken. The Direct Debit Guarantee shown above will apply to all Direct Debit payers. nstrution to your Ban or Building Soiety to pay by Diret Debit Serie user number lease ill in the whole orm eept the bo mared or Oie Use Only using a ball point pen 6 9 9 9 7 0 his is not part o the instrution to your Ban Names o Aount Holders or Building Soiety lease ti one bo to selet the payment type: Single Membership Double Membership 1 iet 2 iets Ban/Building Soiety Aount Number Monthly Monthly An initial payment o An initial payment o 6, then monthly 126, then 6 monthly Branh Sort Code 1 eery 1 wees 26 eery 1 wees 26 eery 26 wees 52 eery 26 wees 52 eery 52 wees 10 eery 52 wees Name and ull postal address o your Ban or Building Soiety To the Manager reerred Start Date i any Ban/Building Soiety You will be notiied in writing, beore the irst payment is taen Address Name Address ........................................................................ ostode ostode lease pay Hampshire and sle o Wight Air Ambulane Diret Debits rom the aount detailed in this instrution, subet to the saeguards assured by the Diret Debit uarantee understand that this instrution may remain with el Hampshire and sle o Wight Air Ambulane, and i so, details will be passed eletronially to my Ban/Building Soiety Email Signatures: or Oie Use Only Date: • his uarantee is oered by all Bans and Building Soieties that aept instrutions to pay Diret Debits • there are any hanges to the amount, date or requeny o your Diret Debit, Hampshire and sle o Wight Air Ambulane will notiy you 10 woring days in adane o your aount being debited or as otherwise agreed you request Hampshire and sle o Wight Air Ambulane to ollet a payment, onirmation o the amount and date will be gien to you at the time o the request • an error is made in the payment o your Diret Debit by Hampshire and sle o Wight Air Ambulane or your Ban or Building Soiety, you are entitled to a ull and immediate reund o the amount paid rom your Ban or Building Soiety you reeie a reund you are not entitled to, you must pay it ba when Hampshire and sle o Wight Air Ambulane ass you to • You an anel a Diret Debit at any time by simply ontating your Ban or Building Soiety Written onirmation may be required lease also notiy us Hampshire and Isle of Wight Air Ambulance Weekly Lottery Payment by Regular Cheque Please complete sections 1, 2, 3 & 4 Section 1: Payment Method by Regular Cheque Please tick one box to select the payment amount: Single Membership Double Membership (1 Ticket) (2 Tickets) Amount of cheque £13 quarterly Amount of cheque £26 quarterly Amount of cheque £26 six monthly Amount of cheque £52 six monthly Amount of cheque £52 yearly Amount of cheque £104 yearly Please make cheques payable to Hampshire and Isle of Wight Air Ambulance. Section 2: Name and Address Full Name* Address* Postcode* Tel No Email Section 3: Data Protection and Consent to Play Please tell us which methods we may use to contact you: Post Phone Email Please let us know which areas of our work you would like us to tell you about: General Newsletter (Remember to give us your email permission) Helimed 56 Magazine (Remember to give us your postal permission) Future challenges and ways to support the Charity (Remember to give us your email permission) Section 4: Age Verification I confirm that I am over 16 and resident in Great Britain. Signature Date / / Your data will be stored in accordance with the Data Protection Act 1998. Hampshire and Isle of Wight Air Ambulance will never sell your data to a third party. Our full privacy policy is available at www.hiowaa.org/cookie-policy.
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