Wicker Lotto-Social Membership Direct Debit Request Form
Email address *
Your First Name *
Your Last Name *
Your access to WICKER LOTTO - Social member DRAW DETAILS
2 x Fortnightly draws of the 50% of the total amount available* to be claimed as winnings.
The more members signed up the more you can win.

Direct debits will be transferred the Thursday of the week for the draw. On most occassions the membership draws will be done on a Friday Night.

*Total Amount Available to win is dependant on the amount of members signed at the time of the draw.

Cancellations can be made via CreswickFNCSerctary, allow 5 days for processing.
Request and Authority to debit
I allow CRESWICK FOOTBALL NETBALL CLUB ABN 74 984 719 118, I request and authorise the CRESWICK FOOTBALL NETBALL CLUB, ID 611315 to arrange a debit to your nominated account to pay for CRESWICK FOOTBALL NETBALL CLUB WICKERS LOTTO DRAW This debit or charge will be arranged by BENDIGO BANK’s financial institution and made through the Bulk Electronic Clearing System Framework (BECS) from your nominated account and will be subject to the terms and conditions of the Direct Debit Request Service Agreement.
I allow CRESWICK FOOTBALL NETBALL CLUBABN 74 984 719 118 request and authorise the CRESWICK FOOTBALL NETBALL CLUB, ID 611315 to arrange a debit to your nominated account to pay for CRESWICK FOOTBALL NETBALL CLUB 50/50 DRAWThis debit or charge will be arranged by BENDIGO BANK’s financial institution and made through the Bulk Electronic Clearing System Framework (BECS) from your nominated account and will be subject to the terms and conditions of the Direct Debit Request Service Agreement. *
Required
Amount of debit
CRESWICK FOOTBALL NETBALL CLUB will debit the amount of $20 PER FORTNIGHT until request for cancellation is received *
Required
Your account to be debited
(Your)Name on account *
(Your)Financial institution name *
(Your)BSB number (Must be 6 Digits) *
(Your)Account number
Your contact details
Your Address *
Your Phone *
Direct Debit Request Service Agreement Page 1 of 3
Direct Debit Request Service Agreement Page 2 of 3
Direct Debit Request Service Agreement Page 3 of 3
Confirmation
By signing and/or providing us with a valid instruction in respect to your Direct Debit Request you confirm that:
• you are authorised to operate the nominated account; and
• you have understood and agreed to the terms and conditions set out in this Request and in your Direct Debit Request Service Agreement.
Your Signature - clicking YES is Signing in accordance with the account authority on your account: *
Required
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