2023 NESMA Holiday Party Raffle Tickets Online Purchase Form

Use this form to purchase your raffle tickets online. Tickets are 1 for $20 and 3 for $50.
You will receive your raffle tickets at the door on the day of the event.
Thank you for supporting NESMA and Good Luck!!!

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Invoice ID

Your Name*

First Name Last Name

Business Name*

Title

Address*

Street Address Address Line 2 City State ZIP Code

Email Address*

Enter Email Confirm Email

Contact Phone*

Is this a mobile phone?*

YES

Raffle Ticket - $20

Price:

Quantity*

Please enter a number less than or equal to 2.

Raffle Ticket 3 for $50*

Price:

Quantity*

Please enter a number greater than or equal to 1.

PAYMENT DETAILS

Total

Credit Card

Cardholder Name

Card Details