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Yearly Lotto Ticket

Members Weekly Lotto / Annual Membership Form (for print)

NAME: ___________________________________________________

ADDRESS _________________________________________________

__________________________________________________________

Phone: _______________________ 

e mail ________________________

SELECT YOUR 4 NUMBERS HERE

PLEASE MARK 4 NUMBERS ONLY WITH An X

Sign here _____________________

Date :____________________

Return printed  form with payment to

The Treasurer , St. Brigid?s G.A.A. Club ,

Tom Russell Park, Navan Road , Dublin 15

Annual Draw membership ?80

Draw will be held on Thursday nights at 10.30 p.m

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