$100,000 Mega Raffle Credit Card Information
to Reserve Your Tickets

 

    Name:

     

     

     

    Address, City, Zip:

     

     

     

    Phone:

     

     

     

    School Family:

    YesNo

     

     

     

    Email Address:

     

     

     

    1 ticket $50.00 or 3 tickets for $100.00

     

     

     

    Number of tickets:

     

     

     

    Credit Card # (Mastercard and Visa only):

     

     

     

    Expiration Date:

     

     

     

    Amount to be Charged: