$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: