Printed from ArielCenter.org

Mega Raffle

Mega Raffle

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Tickets:                           Total:                         
       
$36.00

Personal Information  
Title
First Name:
Last Name:
Email Address:
Phone Number:
Who Introduced You
to Our Raffle?
 

Please consider making a Passover Donation to ARIEL:
I want to make a donation of $ Total: $
 
Credit Card Details
Card Type
Card Number
Expiration Date

Security Code (CUV)
(3-digits from back of card OR for AmEx - 4 digits on front)
Billing Address
Address 1:
City: State:
Post Code: Country:
 
 

 

 

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