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2. Raffle Permit Process

   Raffle permits are available for those who want to have a raffle at games, amusements, and athletic exhibitions, as well as in conjunction with bingo games. NH RSA 287-A applies to raffle permits issued by the Town of Londonderry. 

   To get started, please fill out the Raffle Permit Application. A staff member will contact you if they have questions. You will receive a response to your application within two to three business days. 

   If you have questions or concerns before completing the application, please email Kirsten Hildonen or call 603-432-1100 ext. 153.

4. First Name*
5. Last Name*
7. Email Address*
8. Phone Number*
10. Address 1*
11. Address 2 (optional)
13. City*
14. State*
15. Zip Code*
17. Business / Organization Name*

    Please re-enter your name if not applicable.

19. What type of business / organization?*
    -- Select One --EducationalCharitable (registered non-profit)CivicReligiousVeteranOther
20. Will the total time of your sale of tickets and raffle exceed 12 consecutive hours?*
    -- Select One --YesNo
22. Raffle proceeds will benefit:*
24. Describe what will be raffled:
26. Raffle Start Date*
    Raffle Start Date
27. Raffle End Date*
    Raffle End Date
29. Date, Time, and Location of Drawing:*

31. Conditions of Use: Please review and refer to NH RSA 287-A:1-11 in its entirety.

33. Confirmation*

    I have read and understand NH RSA 287-A and agree to conform to all requirements for conducting a raffle.

    1. I have read and agree to conform to NH RSA 287-A
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit Submit and Print

* indicates a required field