Join the Wildlife Trust Lottery and Win for Wildlife

Please return your completed form to: Membership, Kent Wildlife Trust, , Sandling, , Kent, ME14 3BD. We’ll write to you within 14 days to confirm your entry.

Title Forenames Surname D.O.B. Address

Postcode Telephone Email I am also happy to be contacted by Kent Wildlife Trust about their conservation, events, membership, fundraising and other activities by (please tick all that apply): Post Telephone Email Your details will be used for Kent Wildlife Trust’s purposes only and will not be sold or passed onto any other organisations. How many entries would you like each month? (please tick one box) 1 Entry per month (£2) 2 Entries per month (£4) 3 Entries per month (£6) 4 Entries per month (£8) 5 Entries per month (£10) 10 Entries per month (£20)

Other amount of entries: Entries per month total £

Instruction to your Bank or Building Society to pay by Direct Debit Name and full postal address of your Bank or Building Society To: The Manager Bank/ Building Society Address Service user number 6 2 4 1 8 7 Postcode Reference L O T Name(s) of Account Holder(s) Instruction to Bank or Building Society Please pay Kent Wildlife Trust Direct Debits from the account detailed in this instruction subject to the safeguards assured by Account Number the Direct Debit Guarantee. I understand that this instruction may remain with Kent Wildlife Trust and, if so, details will be passed electronically to my Bank/Buildling Society.

Sort Code Signature(s) Date

Banks and Building Societies may not accept Direct Debit Instructions for some types of account. Kent Wildlife Trust will send you a copy of the Direct Debit guarantee with your confirmation and schedule of payments.

Lottery promoted by S. Campbell. Kent Wildlife Trust Lottery Registered with District Council, under the lotteries and amusements act 1976. Players MUST be 16 years or over. Please see the website for full terms & conditions. A company limited in England and Wales by guarantee 633098.

Head Office: Kent Wildlife Trust, Tyland Barn, Sandling, Maidstone, Kent ME14 3BD Tel: 01622 662012 [email protected] | kentwildlifetrust.org.uk Registered Charity No. 239992. Company No. 633098. VAT Registration No. 974842378.

Protecting Wildlife for the Future