Lucky Draw Winner Announcement Form

Lucky Draw Winner Announcement Form
Congratulations! Please complete this form to confirm your identity and claim your prize. All information will be used solely for winner verification and contact.
Lucky Draw Winner Announcement Form
Full Name
First NameLast Name
Email Address
example@example.com
Mobile Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mailing Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Unique Winner Code
Preferred Contact Method
Date Notified
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Upload Proof of Identity (e.g., winner notification email or letter)
Cancelof
Additional Notes or Special Instructions
Should be Empty: