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Share Your Moment Form

Describe your moment in 50 words or less (Required)

Upload your optional video/image/document (20 MB max)

You can support your entry with a short film, a drawing or even a photo. Be creative!

Once you have described your moment in the above window and attached any documents, images or videos, please complete the fields below and submit your entry. Fields marked with the red box are mandatory.

Your E-Mail Address (Required)

First Name (Required)

Last Name (Required)

Address (Required)

Suburb (Required)

Postcode (Required)

Contact number (Required)

Gender

Male
Female

Date of Birth (Required)

/ /

Do you play any of the following games?

Lotto (Sat / Mon / Wed)

OZ Lotto

Powerball

Cash 3

Soccer Pools

Scratch'n'Win

How did you find out about this competition?

Newspaper

Radio

Online (websites)

I have read and agree to the Terms and Conditions for the Share Your Moment Competition (see link at top of page) (Required)

I would like to receive information on Lotterywest competitions and promotions

If you are attaching a large file please be patient as it may take a while to upload.