[logo] QUEEN OF THE SOUTH F.C. LTD. [logo]
I wish to support Queen of the South FC by joining the weekly draw.

Please enrol me for ................. ticket(s) per week via the following method:
1. Standing Order [..........]
2. Cash to Local Agent [..........]
3. Door to Door Collector [..........] Agent (if known) ...................................
Name .......................................................................................................................
Address ...................................................................................................................
Post Code ...............................................................................................................
Tel ..........................................................................................................................
If you wish to pay by Bank Standing Order, please complete the form below. Each ticket costs 1.00 per week payable monthly/quarterly/annually.
Monthly Amount 4.34
Quarterly Amount 13.00
Annual Amount 50.00
To: Bank and Branch Name .....................................................................................

Please pay to 82-62-13, Clydesdale Bank, 84-86 High Street, Dumfries DG1 2BJ.

For credit of Queen of the South F.C. Dev. Account No. 30460449. The sum of .........
followed by monthly/quarterly/annual sums of .......... until further notice, commencing
................................................
From (Account Name) ............................................................................................
Account No. ...........................................................................................................
Sort Code ...............................................................................................................
Please quote membership No. ............................................................(Leave Blank)
Signature ................................................................................................................

Please return to Q.O.S.F.C. Ltd. Palmerston Park, Dumfries. DG2 9BA