Company Information

Company Name:

User Nickname:

Contact Email:

Address:

Phone:

Business/Charity No.



Login Password for Lottoraiser:

This is not a password for any of your other accounts!

Please note password is one you choose to login into Lottoraiser.ie with.




Receipt Information

The person who will require receipt records, for example if you have a treasurer. We will email this person with receipts to keep track of all lottoraiser payments made.

Name:

Email:




Bank Details

Name of Bank

Account Name

Bank Account IBAN

Bank Account BIC




Lotto Draw Details

Some details of your lotto draw. Please enter in Current Jackpot Amount with date of next draw.

Date of next Draw:

Can ignore below for 50/50 draws

Starting Jackpot Amount

Jackpot increase if not won

Current Jackpot Amount




Additional Message