Agent – National Lottery of Tanzania

Expression of interest

Name:*

Phone number:*

Email address:*

Name of store:*

Type of store:*

Region:*

Street Address: *

Town:*

Opening Time:*

Closing Time:*

Picture (Inside Store):* Click on the button to attach a picture

Picture (Outside Store):* Click on the button to attach a picture

Receive marketing e-mails:

Yes

* Mandatory field