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Businesses - Apply Online

Please complete the form below to make an online application and payment for the Lottery.

If you wish to pay by standing order or cheque please download our application form. You can complete the standing order form and send to Freepost RSHR-JJEG-KYCL, Pride in Penrith Lottery, Penrith, CA11 7AY. If you wish to pay by cheque, these should be made payable to 'Pride in Penrith Lottery' and returned with the completed form. If you have any queries please email info@prideinpenrith.co.uk.

Business Member Application Form

Business Details

Business Name *
Contact Name *
Address 1 *
Address 2
Address 3
Town/City *
County *
Postcode *
Telephone
Email *

Choose your Numbers

Please choose 4 numbers between 1 & 31 for each line you would like in the draw and write them in the boxes below. If you would prefer a lucky dip please tick the box.

Line 1
or
Tick for Lucky Dip
Line 2
or
Tick for Lucky Dip
Line 3
or
Tick for Lucky Dip
Line 4
or
Tick for Lucky Dip
Line 5
or
Tick for Lucky Dip

Payment Preferences

1 Line *
£8.68 monthly
£26.04 quarterly
£52.08 six monthly
£104.16 annually
2 Lines
£17.36 monthly
£52.08 quarterly
£104.16 six monthly
£208.32 annually
3 Lines
£26.04 monthly
£78.12 quarterly
£156.24 six monthly
£312.48 annually
4 Lines
£34.72 monthly
£104.16 quarterly
£208.32 six monthly
£416.64 annually
5 Lines
£43.40 monthly
£130.20 quarterly
£260.40 six monthly
£520.80 annually

Please make payments until further notice.

If you have any queries please contact info@prideinpenrith.co.uk or call 07518 011644.

We will not use your details for anything other than processing your application.

If you do NOT want your business name to be published if you are a winner, tick here

We will not disclose you address in any case.

Full Lottery rules are available on request.

Registered with Eden District Council under the 2005 Gambling Act

Please use the 'proceed to payment' button to enter your payment details and complete your application.