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EMO "36" Lucky Star Syndicate Application Form
TO COMPLY WITH UK GAMING LAWS, ALL BOXES MUST BE FULLY AND ACCURATELY COMPLETED Your Full Name: Home Address: Email Address: Telephone No. (include STD code) Mobile No. Date of Birth: (for example - 31/08/1968) Please click here for Terms & Conditions and full details of Membership. Number of Weeks Play: (Minimum payment 12 Weeks per line) (Minimum membership 52 Weeks per line) UK Membership Fees Total: £ at £2.00 per week. International Membership Fees Total: € at 2.00€ per week. Cheque/Money Order Number: (for your reference). Do NOT send cash. (N.B. If more than one player is sponsoring a single line, each must complete and sign their own application form) |
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Make Cheque/Money Order payable to; Mr G W Gill |
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