eLotteryBingo

Registration Form

Please provide the following information (items marked * must be completed)

Organisation Name *
Organisation Type *

Select Organisation Type
Your Name * First Last
Your Address *
Street Address

Address Line 2

Town/City

Postcode
Street Address and Town must be entered. Address Line 2 may be left blank. Postcode must be entered and be valid ANN NAA A=alpha N=number

County
Phone *

Telephone Number must be valid
Mobile Phone
Email Address *

Must be a valid Email Address
Repeat Email Address *

Must be the same as the Email Address entered above
Choose a Username (6 - 20 chars) *

Username must be 6 - 20 chars alphanumeric and start with an alpha
Choose a Password (6 - 20 chars) *

Choose a password from 6 - 20 characters
Repeat Password *

Must be the same as the password entered above

Registration

Please complete the Registration Form and click on the Submit button. You will then receive an email confirming your username and password that will enable you to administer your Lottery Bingo games. You will also be sent a template for a Lottery Bingo Application Form so you can start recruiting members straight away.

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