Alleviating Tragedy with Compassion. Coordinating Crisis with Expertise.

24 Hour Emergency Hotline

You must have JavaScript enabled in order to use this order form. Please enable JavaScript and then reload this page in order to continue.

Drawing Date: October 31, 2019

YES! I want to help Misaskim assist others when they face tragedy, crisis, or the loss of a loved one.
Please enter my donation into your GRAND RAFFLE drawing as follows:

$36

Entry Wins

$5,000

Cash

$54

Entry Wins

$10,000

Cash

$100

Entry Wins

$18,000

Cash

$180

2 Entries for

$18,000

Cash

$360

5 Entries for

$18,000

Cash

$500

10 Entries for

$18,000

Cash

Additional Donation $

Donation Total: $

Personal Information

First Name: *

Last Name: *

Company Name:

Donor ID:

Address: *

City: *

State: *

Zip Code: *

Country: *

Phone Number: *

Cell Phone:

Email Address: *

Payment Details

Card Type: *

Card Number: *

Exp. Month: *

Exp. Year: *

Security Code: *

Additional Comments:

Please mail a receipt to the address above (in addition to the receipt I will receive via email).

Only enter this field if you were told to do so by a staff member.

Misaskim is a non-profit 501(c)3 organization. All contributions are tax deductible. Restrictions apply. This $18,000 Misaskim Sweepstakes is not in conjunction with any other institution. Winners must consent to the use of the respective name & photo for the advancement of the Misaskim cause. No purchase necessary. Misaskim reserves the right to change the date of the drawing.

Join Our Mailing List