Contest Entry Form

RAFFLE ENTRY FORM

FORMULARIO DE INSCRIPCIÓN A LA RIFA
Full Name of the Contester *

First NameMiddle NameBoth last names
Date of Birth*

MonthDayYear
Date
Please enter your valid phone number*
Email*

Confirmation Emailexample@example.com
How did you hear about the raffle?

Heard From a FriendSOCIAL MEDIASERVICIO INTERNACIONALOther
Please Specify "Other"

SUBMIT ENTRIES BEFORE:
MAY 30

PRIZES AWARDED:
JULY 15

Each entry will receive a text message to check their email for their ticket.

All tickets will enter the spin wheel. Winner will receive a text message to check the email address they entered on their entry. MUST respond to email TO WIN!!! winner will have 72 hours to respond to email of winning ticket and by 5pm the 10th day from the date of winning email sent will forfeit the prize.

100 tickets to raffle so purchase as many as you want! Faster the 100 tickets are gone by the deadline the gaurantee the raffle will close on schedule.

If raffle closes at deadline and all 100 tickets are not purchased then it will roll into the new raffle JUNE 30-AUGUST 30 until all raffle tickets are gone. All entries will also roll over to the next raffle until all 100 tickets are gone. ALL WINNERS MUST PICK-UP THEIR PRIZE AT OUR OFFICE BETWEEN 10AM-4P MONDAY - SATURDAY. 387 Haywood Lane, Nashville TN 37211.

Time of submission*

Hour : Minutes Minutes

AM/PM Option
TODAY'S Date*

MonthDayYear
Date
My Entries:
prevnext( X )
Each Entry ticket
$20.00 Each ticket $20

Total

$0.00
CHECK HERE

Payment Methods

Tarjeta de Débito o Crédito

Choose from one of the PayPal options to make your payment.

Should be Empty:

RAFFLE ENTRY FORM