Please complete the form below or call 01772 59 88 55 / 07784475151 Name (required) Address Line 1 (required) Address Line 2 Town (required) County (required) Post Code (required) Tel No (required) E-mail Address (required) I/we would like to join the FSL Gold Lottery (I can confirm that I am over 16 years of age) Number of chances per week - £1 per chance —Please choose an option—OneTwoThreeFourFive