Raffle Information Submission Form

Send your input by completing information below.

You may submit a listing even if you're not running the raffle (but it helps), all we ask is that you make sure all information is accurate and up to date. 

   
Raffle Organizer Information:  (* Required Fields)
Charity/Organization: 	*
Address:       		 
City:          		  State: 
Zip Code:      		 
Phone:         		 If known.
Web page:      		  If available.
E-mail:        		  User@domain.xxx
               		If you wish to receive email from the public.

Are you running the raffle?
Yes  No  Please select one

Description of what is being raffled: (*required)


Cost per ticket:		*
Number of tickets to be sold:	*
Raffle Date:   			*
Raffle Time:      		*
Location of Raffle:		*
 
The following information will not be published.
If you wish to have your email address listed, please include it above.

Your name:   * First and last
Your E-mail: *User@domain.xxx

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