$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: