Thank you for supporting RUHX! Money Raised through your support of the lottery will go towards patient care at the RUH. Simply fill in the form below. If you win you’ll receive your prize via payslip as non-taxable income.

Please complete the form below.

Title *

Full Name *

Home Address *

Postcode *

NHS Email *

Ward/ Department *

Ext Number *

Number of shares *

i.e. £4.33 = 1 Share

My RUH Bath NHS Trust payroll number is:

Or other NHS Trust Payroll number is:

Agreement *

• I instruct The RUH Payroll Department to deduct the total sum below from my salary until further notice.

The sum of £____ (Please enter below) Per Month (£4.33 per share per month) *

Date *

Submit

For any questions please phone 01225 825691 or email hello@ruhx.org.uk

The total funds received each month for the lottery will be split 50/50 between cash prizes & The RUHX Charity. You can sign up for as many shares as you like. To take part in the staff lottery you must be an employee of the Royal United Hospitals Bath NHS Foundation Trust. *£1 per week is equivalent to £4.33 per month.