Melbourne Cup

Sweep winnings details form

Winnings Form

Please fill out all details in form below to collect your Melbourne Cup winnings from events held at Blackbird or Donna Chang.

First Name *

Last name *

Email *

Phone Number *

Ticket Serial Number *

Horse number on your ticket *

Would you like to donate your winnings back to MS Queensland? - If No please fill account details *

Yes
No

Account Name *

BSB *

Account Number *

Would you like to hear more about how your support has made a life-changing impact? *

Yes, I'd love to
No, thank you

I confirm that all above details provided are correct for electronic transfer

Yes, all details are correct

Open 8am to 4pm on weekdays.