Section A:

Applicant Name

• Start with your last name. In the U.S., last name refers to surname or family name.
• Write your first name next. That is your given name.
• Last on the line goes your middle name. In some cultures it may be your father’s name.

In any case, your name should match the one on your birth certificate and/or passport.

Applicant Place of Birth

First write your town of birth, then province, then country. For example: San Fernando, Trinidad, Trinidad & Tobago. Do not give the name of the hospital in which you were born or the continent. If you were born in the capital, you do not need the province. Example: Paris, France.

Applicant Date of Birth

• Start with the day on which you were born, then the month, then the year. For example, someone who was born on May 29, 1960 should write: 29/05/1960. Do not write the day of the week, such as Monday, Tuesday, etc.
• If you do not know the day or month in which you were born, write “unknown” next to the date of birth.

Completed:

• Secondary/High School: check this box if you have had approximately 12 years of education.
• Trade School: this is the box to check if you have had specialty technical training, usually after secondary school.
• University: if you have a university or college degree, check this box.
• Post Graduate School: Refers to completed studies after receiving a university or college degree.

Occupation/Profession:

• Give your current job.

Top of page

Section B:

• Complete this section only if you are legally married. This is where all the information for your wife or husband goes. It should be in the same order as yours was in Section A.
• You must include the required information for your spouse even if you are separated or not living together. If you are legally divorced, you do not need to include that information.
• If you and your spouse are each completing a separate application, make sure that your information is under Section A and your spouse’s information is under Section B on one of the applications. On the other one, do the reverse. Your spouse’s information goes under Section A (as he/she becomes the applicant) and your information goes under Section B. By sending two separate application forms (one for you and one for you spouse), you double your chances of winning. If one of you wins, the other wins automatically too.

Section C:

• List all your unmarried children under 21 years of age, even if you are divorced, if the children are not living with you or if you are not legally married to their father/mother.
• If your spouse has children of his/her own, they must also go on your application form.
• If you have other children living with you, you can only include them on your application if they have been legally adopted.
• Again, start with last name, then write first name, then middle name. Dates and places of birth should be specified as in the previous sections. If you have more than 3 children, continue listing them on the back of the application form in the same exact way.
• Do not list any other family members even if they are living with you and you are responsible for them.
• Children who were born before November 1, 1983 must use a separate application form and apply on their own.

Top of page

Section D:

Signature

Sign the application form in your native language/mother tongue. If your native language is written in Arabic, Hebrew, Persian, Cyrillic or other, sign your name using the characters of that language and in the way it appears on documents that you sign in your country.

Photographs

• You must include an individual passport photo of yourself that are exactly 50 mm x 50mm (square) [ 2 x 2 inches square ]. If you are married and have children, you must also include a passport photo of your husband/wife and a passport photo of each of your children. You must include photos even if you are separated from your spouse, if you are not living together, if he/she is in another country or born in the United States or if he/she is not completing a separate application form. The same is valid for all children listed on your application form.
• Do not tape, staple or glue the photos to the application form.
• Each person photographed must be directly facing the camera; the head should not be tilted up, down or to the side, and should cover about 50% of the area of the photo.

Top of page

Section E

• Applications will not be processed unless payment is included. No exceptions will be made.
• If you are sending a single application, your fee is $50.00 (U.S.) for this lottery, $90.00 for the next two lotteries or $200.00 for Lifetime Membership.
  If you and your spouse are each sending a separate application, the fee for both of you is $75.00 (U.S.)  for this lottery, $125.00 for the next two lotteries or $300.00 for Lifetime Membership. Click here to learn more about Lifetime Membership.
  If you have received only one application form, you can photocopy it for your spouse. Please include two (2) applications. One for the husband (as applicant) and another other one for the wife (listed as applicant). The family application doubles your chance of winning. If one spouse wins, the other one wins automatically as well.
• All methods of payment are listed on the application form. If you decide to send cash, we suggest that you send it by registered mail so that it does not get lost.
• If you wish to send a bank wire transfer, please include an additional $15.00 (U.S.) for bank surcharges. Our bank’s name is Downey Savings and all the information required for the transfer is on the application form.
• When making payment through Western Union, ask about Quick Pay. If it is not available in your country, please make the payment to Braden Pollock.
• For payments made by bank wire transfer or Western Union, please include a copy of your receipt with your application form.
• If you are making payment by credit card, please specify your exact credit card number, expiration date (month and year), the credit card holder’s name and his/her signature.
  We only accept Visa, Master Card and American Express.

Top of page

Section F

• This is where your name and complete address are written. Be as specific as you can by including phone and fax numbers, as well as email address if you have one.
• If you would like us to forward your results and any other correspondence to someone else, please specify this by giving us that person’s name and address under this section.

REMEMBER TO:

• Print clearly and legibly in English only on your application form.
• Check to see if you are eligible. Eligibility is determined by your country of birth, not citizenship. For example, if you were born in India but are a citizen of Australia, you are not eligible. If you were born in a non-eligible country but your parents were not residents of that country at the time of your birth and moved shortly after you were born, you may be eligible. You may also be eligible if your spouse was born in an eligible country. You are responsible for determining your eligibility. Fees are non-refundable.
• Make sure all the information on your application form is correct. You may be disqualified if you fail to provide truthful and accurate information.

If you have any questions or doubts, do not hesitate to contact our offices and our staff will be happy to guide you through the process of completing your application form. Our phone number in the United States is 001-818-884-8075 and working hours are from 8 a.m. (in the morning) until 5 p.m. (in the afternoon), Pacific Standard Time.