Please Note: All fields need to be completed Section 1: Promoter details Name of promotion Company/promoter name Company/promoter registration number Company/promoter physical address Company/promoter URL/website link/link to T&C’s Details of person responsible for running the competition First Names Surname ID Number Email Address Advertising agency Name Registration number Physical address Section 2: Prize details Can people under the age of 18 years enter the promotion Details of how winners will be selected Date on which prizes will be drawn Date on which winners will be notified Details of how winners will be notified Details of how prize will be redeemed/handed over Section 3: Audit information First name of person Surname of person ID number of person Designation person auditing the promotion (accountant/attorney) First name of person responsible for selecting the winner Surname of person responsible for selecting the winner ID number of person responsible for selecting the winner Email address of person responsible for selecting the winner Telephone number of person responsible for selecting the winner Please enter security code in field below