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Bills Raffle
Please complete the form below to purchase your raffle ticket(s).
Tickets
*
Quantity
$5
-
1 Ticket
0
1
2
3
4
5
6
7
8
9
10
10
$10
-
3 Tickets
0
1
2
3
4
5
6
7
8
9
10
10
Billing Information
Name
*
First Name
Last Name
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Email
*
Verify Email
*
Phone
*
If you are purchasing as a gift, please list the name and phone number of the recipient
We will list this person as the entrant and they will be the person who wins if their name is drawn.
Would you like to be added to our email list?
*
Yes
No
Already on it
Add 3% to my total amount to help cover the payment processing fees
