JLIC – Blind Raffle

1. Commit to buying a ticket(s).

2. Once you have submitted your payment information, you will be randomly assigned a number between 1-180. That number is your donation amount and raffle ticket number.

3. Be entered into a raffle for the chance to win $2,500!

Number of Tickets:

Ticket Quantity *

Designate a Campus: *

Personal Information:

First Name *

Last Name *

Phone Number *

Email *

How did you hear about the raffle?

Address:

Street Address *

City *

State *

Zip *

Country *

Payment Information: Accepted credit cards

Name on Account *

Credit Card Number *

Month *

Year *

CVV *

I acknowledge that my credit card will be charged a number at random between $1 and $180.

Purchase not necessary