Mega Raffle Ticket Form

Only 4,000 tickets will be sold. Tickets are $100 each. (Tickets purchased by credit card will incur a $5 processing fee.) A total of 40 prizes totaling $169,250 will be awarded. While tickets are available at Blessed Sacrament, St. Dominic, St. Francis, St. Peter and QND, this site is only able to securely accept a payment by credit card. One (1) ticket per submission. If you have any questions, please email support@quincymegaraffle.org or 217-224-2598.

Name(Required)

First Last

Card Type(Required)

Credit Card Number(Required)

Expiration Month(Required)

Expiration Year(Required)

CSC (3 digit security code)(Required)

Address(Required)

Street Address City State ZIP Code

Phone A(Required)

Phone B

Email(Required)

I wish to have $10 of my ticket price:

Donated to the ONE school

Divided equally among the schools checked

Schools:

Blessed Sacrament

St. Dominic

St. Francis

St. Peter

QND

Ticket Co-Purchaser(s)

Ticket Seller’s Name (Adult – 18 or older)

Total to be charged: $105.00(Required)

I agree for payment card to be charged $105.00 for this purchase.

Mega Raffle Ticket Form

In This Section