Online 50/50 Raffle Ticket Purchase

February 9th, 2024 at 5:30pm | Please fill out this form and click submit.

Name

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Email

Phone

Address

Payment

1 ticket ($5) 2 tickets ($10) 3 tickets ($15) 4 tickets ($20) 5 tickets ($25) 6 tickets ($30) 7 tickets ($35) 8 tickets ($40) 9 tickets ($45) 10 tickets ($50) 11 tickets ($55) 12 tickets ($60) 13 tickets ($65) 14 tickets ($70) 15 tickets ($75) 16 tickets ($80) 17 tickets ($85) 18 tickets ($90) 19 tickets ($95) 20 tickets ($100) Custom ($0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

February 9th, 2024 at 5:30pm

Please fill out this form and click submit.

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