Virgin Islands Lottery - Second Chance Vendor Application

Please have the following documents as images ready to upload here before proceeding with this application:
Valid Picture Id, Business License, and Company Digital logo file.

Please be sure to allow/whitelist emails from win@winvilottery.com, so you can receive our emails,
and it doesn't go to your spam folder or get blocked.

(*) All fields are required

Date of Submission(*)

Please select today's date

Business Name(*)

Please enter your company's name

Contact Name(*)

Please enter your first and last name

Email Address(*)

Please enter a valid email address

Phone Number(*)

Please enter your phone number

Type of Business(*)

Please enter what type of business

Company Website URL

Please enter the full url of your company website so we can link to it. If you do not have a website, please enter “none".

Upload a copy of your Business License(*)

You may take a picture of your business license and upload that image here. (Valid file types: jpg, jpeg, pdf, png, tiff)

You may take a picture of your business license and upload that image here. (Valid file types: jpg, jpeg, pdf, png, tiff, gif)

Upload a valid Picture ID(*)

You may take a picture of your valid picture id (such as drivers license or passport, and upload that image here. Valid file types: jpg, jpeg, pdf, png, tiff)

You may take a picture of your valid picture id (such as drivers license or passport, and upload that image here. Valid file types: jpg, jpeg, pdf, png, tiff, gif)

Upload Company Logo(*)

PNG file - Your company logo on transparent background is preferred. (Valid file types: jpg, jpeg, pdf, png, tiff)

PNG file - Your company logo on transparent background is preferred. (Valid file types: jpg, jpeg, pdf, png, tiff, gif)

I have read and agree to the Terms and Conditions(*)

Yes By submitting this application form, I agree to honor VI Lottery 2nd Chance $200 Gift Cards. Thus providing the $200.00 value products/ services when presented with signed and authorized Gift Card. Read the Second Chance Vendor Terms & Conditions.

By submitting this application form, I agree to honor VI Lottery 2nd Chance $200 Gift Cards. Thus providing the $200.00 value products / services when presented with signed and authorized Gift Card. I further grant the VI Lottery permission to publicize my Business name and logo as Prize provider to be included in printand digital advertising along with the www.winvilottery.com website.

Payment Details

Email Invoices to win@winvilottery.com.
Invoice must include the VI Lottery 2nd Chance Gift Certificate Number.
VI Lottery will provide payments within 5-7 business days.

Second Chance Vendor Application

Payment Details

Vendors Signup Today Using the Above Form!

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