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.

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