Sheet 1: 50-50 Application Form

	
	
	
	
	
	
	
	
	
	

		


		
 50/50 RAFFLE LICENCE APPLICATION FORM
		


		


		


		


		


		


		

 
		
		
	

		


		
To receive your gaming licence, please complete the application, save  changes and email this form to campaignsupport@myunitedway.ca
Please allow three business days to process your license.

		
	

		


		
	

		


		
Today's Date: 
		


		
Name of Raffle Chair:
		


		


	
	

		


		
Organization Name:
		


		
Raffle Chair Email:   
		


		


	
	

		


		
Organization Address:
		


		
Raffle Chair Phone:
		


		


	
	

		


		


		


		


		


		
Account ID (Internal Only)
		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		
Event Details
		
Please list all dates and locations the 50/50s will be held.
		


	
	

		


		
Draw Date
		
Draw Location (Organization Name, Address, City, Postal)
		


	
	

		


		


		


		


	
	

		


		


		


		


	
	

		


		


		


		


	
	

		


		


		


		


	
	

		


		
Start Date for Ticket Sales
		


		


	
	

		


		
Please check:
		


		


		


		


		


		


		


		


		


		


	
	

		

 
		
		


	
	

		

 
		
		


	
	

		


	
	

		


		


	
	

		


		
Ticket Details
		
Identify the color, price and quantity of the tickets to be used for the event.
		


	
	

		


		
Please note, as per AGLC regulations:
 - Single and discounted tickets must each be a different colour. (e.g. 1 ticket for $2 blue, 3 tickets for $5 green, etc.)
 - You must make single tickets available for sale, you cannot only sell discounted tickets
		


	
	

		


		
Ticket Type
		
Colour of Ticket
		
Tickets & Ticket Sets Available 
		
# units
		


		


		
Price 
		
Total Ticket Qty
		
Max Profit
		


	
	

		


		
Single Ticket
		


		
10001
		
Single
		
Tickets
		
for
		
$0
		
10001
		
$0
		


	
	

		


		
Discount # 1
		


		


		
Sets of 
		


		
Tickets
		
for
		
$0
		
0
		
$0
		


	
	

		


		
Discount # 2
		


		


		
Sets of 
		


		
Tickets
		
for
		
$0
		
0
		
$0
		


	
	

		


		
Please check:
		


		


		


		


		


		


		


		
Total Ticket Value:
		
$0
		


	
	

		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


	
	

		


		
EXAMPLE: 
		


		


		


		


		


		


		


		


		


		


	
	

		


		
Ticket Type
		
Colour of Ticket
		
Tickets & Ticket Sets Available
		
# units
		


		


		
Price 
		
Total Ticket Qty
		
Max Revenue
		


	
	

		


		
Single Ticket
		
Blue
		
100
		
Single
		
Tickets
		
for
		
$2
		
100
		
$200
		


	
	

		


		
Discount # 1
		
Red
		
100
		
Sets of 
		
3
		
Tickets
		
for
		
$5
		
300
		
$500
		


	
	

		


		
Discount # 2
		
Green
		
100
		
Sets of 
		
5
		
Tickets
		
for
		
$8
		
500
		
$800
		


	
	

		


		


		


		


		


		


		


		


		


		
Total Ticket Value:
		
$1,500
		


	
	

		


		
Questions? Call us at 780-990-1000 or email campaignsupport@myunitedway.ca
		


		
More to fill out on reverse…
		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		
Prize Description: 
		
Please identify the prizes to be awarded and their approximate retail value
		


		


		


		


		


		


		


		


	
	

		


		
Prize Description
		
$ Retail Value
		


		
The total prize value must be at least 20% of the Total Ticket Value for the raffle. (For example, if the total ticket value is $1000, the prize value must be at least $200.)
		


	
	

		


		
Percentage (50%) of Total Ticket Value
		
 $-   
		


	
	

		


		


		
 $-   
		


	
	

		


		


		
 $-   
		


	
	

		


		
Total Prize Value:
		
 $-   
		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		
Estimated Expenses:
		
Document all expenses to be covered from proceeds of this raffle.
		


		


		


		


		


		


		


		


	
	

		


		
Advertising
		
 $-   
		


	
	

		


		
Printing
		
 $-   
		


	
	

		


		
Other 
		


		
 $-   
		


	
	

		


		
Total Expenses:
		
 $-   
		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		
Financial Reporting
		


		


		


		


		


		


		


		


		


		


	
	

		


		
The Raffle License Financial Form must be submitted to United Way of the Alberta Capital Region within a maximum 10 days following the conclusion of the event. Failure to submit these reports or to comply with the terms and conditions of the license may affect whether future licenses will be issued. 
Completed Financial Forms can be:
 - Emailed to campaignsupport@myunitedway.ca,
 - Mailed to 15132 Stony Plain Road, Edmonton, AB, T5P 3Y3
		


	
	

		


		
Please check:
		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		
Licensing Information
		


		


		


		


		


		


		


		


		


		


	
	

		


		
The Alberta Gaming, Liquor & Cannabis Commission (AGLC) is responsible for administering and regulating the gaming industry in Alberta, including the licensing of charitable gaming activities. Only charities or religious groups are licensed. All proceeds from the licensed activity must be used for charitable or religious activities. 




		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		
Licensing Process
		


		


		


		


		


		


		


		


		


		


	
	

		


		
The AGLC Regulatory Division is responsible for reviewing the applications, issuing gaming licenses, and enforcing the Act, Regulation, policies and terms and conditions. The AGLC must approve any changes to the approved license or approved use of proceeds. Inspectors may visit gaming events to provide advice and information and to ensure that all requirements are being met, and/or conduct investigations of any alleged irregularities.
		


	
	

		


		
Please check:
		


		


		


		


		


		


		


		


		


		


	
	

		


		

 
		
		


	
	

		


		


	
	

		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		
To Submit This Application
		


		


		


		


		


		


		


		


		


		


	
	

		


		
1) Ensure all required sections are filled out.
		


	
	

		


		
2) Review and check all boxes to agree to adhere to United Way's raffle guidelines.
		


	
	

		


		
3) Save and email this form to CampaignSupport@myunitedway.ca
		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		
If approved, United Way will be able to process and e-mail your licence and documentation forms within 3 business days.