Please complete this form if you hold a winning lottery ticket bought from one of our Sue Ryder shops for prizes over £10. - Prizes under £10 can be claimed in cash at participating Sue Ryder stores.
YOU MUST ALSO SEND YOUR WINNING TICKET TO:
Furness Business Park
Peter Green Way
Barrow-in-Furness, LA14 2PE
It is your responsibility to ensure the ticket arrives safely. Sue Ryder accepts no responsibility for tickets lost in the post. Upon receipt, this form will be matched with your ticket and a prize issued. All prizes are paid by cheque, made payable to the exact name you have listed below and will be posted to the address you have quoted.
First Name: *
Last Name: *
Contact Telephone Number:
Contact Email Address: *
I confirm that I am over the age of 16. *
Address Line 1: *
Address Line 2:
Post Code: *
LOT Barcode Number: *
Lottery Number: *
Claim Amount: *
Winning Draw Date: *
Note: Please ensure that the winning draw you have checked your ticket against matches the date printed on your ticket.
Your support helps Sue Ryder continue to provide care. We’d love to keep in touch with you to tell you about our work and how you can support it.
We will only contact you electronically if you agree to be contacted in this way. Please tick the relevant box if you’d like to receive:
We may contact you by post or by telephone unless you have asked not to be contacted. If you would prefer not to be contacted in this way please tick the relevant box: I do not want to be contacted by: