Register to Join

Use this form to apply for membership of the Hospice Lotteries Association.

An application will be considered for any hospice, or lottery operated on behalf of a hospice, which meets the criteria as set out in our Terms & Conditions of Membership

Please note: Applications will be considered for approval by the Board of Directors prior to any subscription fees being requested.

Please Complete the Form

Hospice Name *
Hospice Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Lottery Website *
Department Email
Email for Subscription Renewals

Primary Contact

First Name *
Last Name *
Position *
Email *
Phone

Secondary Contact

First Name
Last Name
Position
Email
Phone

Lottery Details

Type of license held *
Gambling Commission non-remote
Gambling Commission ancilliary
Gambling Commission full-remote
Local Authority
None (license applied for)
Types of lotteries run *
Weekly
Raffles
Scratchcards
Lottery Administration *
Lottery Software
Membership Level *
HLA Member
Use this area to provide more information to your support your application:
More information

Login Details

Username *
Password *

I have read the T&C's of Membership *
Yes

Verification

Please enter any two digits with no spaces (Example: 12)*
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Register to Join

Use this form to apply for membership of the Hospice Lotteries Association.

Please Complete the Form

Primary Contact

Secondary Contact

Lottery Details

Login Details

Verification

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