Please fill in our 100 Club lottery draw application form below.

Please read the 100 Club Rules here before filling in the form.

In addition, please make arrangements with your bank so that the money can be paid each month directly into Dial’s bank account on the 15th of the month.

Dial West Cheshire bank account details

Account Name Dial West Cheshire Bank CAF Bank, Kings Hill, West Malling, Kent ME19 4TA

Sort Code 40-52-40 Account number 00006618


    I agree to pay Dial West Cheshire 100 Club £5 per month, per number entry, starting on
    the 15th of the month indicated below until further notice and to abide by the rules of the club.

    We will pay prize money by cheque posted to your home address. If you would prefer to receive these by BACS transfer we will call you to take your bank details.

    I agree to records relating to my membership being held for the sole use of Dial West Cheshire Lottery in compliance with the Data Protection Act and General Data Protection Regulation (GDPR).

    I confirm that I am over 16 years of age.

    I confirm that I have read the 100 Club rules.