Bonner & Prendie - Acceptiva

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

GRAND PRIZE $20,000
2ND PRIZE $2,500
3RD PRIZE $1,000

$100 per raffle ticket

Drawing will be held June 2024 - Grand Prize Seller Reward $1,000

Qty

Description

Amount

Total

One Raffle Ticket

$100.00

---

Total: $0.00

Payer Details

First Name: *

Last Name: *

Class Year:

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone: *

E-mail: *

A receipt will be e-mailed to this address.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *

Name on Account: *

Routing Number: *

Account Number: *