CRUK Weekly Lottery | prize claim

Ticket number *

Draw date (DD/MM/YYYY) *

Transaction ref * Can't find your transaction reference

Title *

First Name *

Surname *

Date of Birth * (you must be 16 or over to play)

Day

Month

Year

You must 16 or over to play or claim a prize.

Postcode *

Address Line 1 *

Address Line 2

Town/City *

Phone Number

Email *

Please provide your email address in case we need to contact you about your lottery entry

Confirm Email *

Would you be happy for us to contact you by email to ask you about winning a prize in our lottery?

Yes

You can change your mind at any time by contacting [email protected]

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Your details will be stored securely and used only for the purpose of paying your prize.

Name of account holder *

Account number *

Sort code *

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