Ticket Order Form 2024 Eligibility Confirmation* I am 18 years of age I am in the province of Manitoba HiddencustomeridMain LotterySingle Raffle Ticket Quantity*Single Raffle Ticket Price: $ 100.00 CAD Quantity 3 Pack Tickets - Call for Availability3 Pack Raffle Ticket Quantity3 Pack Raffle Ticket Price: $ 250.00 CAD Quantity Add-on Lottery50/50 tickets may only be purchased in conjunction with a $100 or 3 for $250 Main Raffle Ticket.Do you want to order 50/50 Addon Tickets as well? No Yes 50/50 Add-on Single Ticket Quantity50/50 Add-on Single Ticket Price: $ 20.00 CAD Quantity 50/50 Add-on 5 Pack Tickets Quantity50/50 Add-on 5 Pack Tickets Price: $ 50.00 CAD Quantity Total $ 0.00 CAD Contact InformationAll tickets issued will contain the same information. Tickets cannot be individualized. You may include a maximum of three names on your tickets.Name* First Last Additional Name First Last Additional Name First Last Email* Phone*Cell PhoneMailing Address* City / Town* Province* Postal Code* Must be Manitoba Postal CodeAdditional InformationHow did you hear about this lottery?Previous BuyerBrochure in the MailNewspaper730 CKDM Radio Station880 Q Country Radio Station96.1 Bob FM Radio Station101.1 Pure Country Radio Station94.7 Star FM Radio StationFacebookOtherOther Payment InformationCredit Card* MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name Visa and Mastercard Accepted OnlyAdditional fees may be charged by your credit card provider.Authorization* By checking the box above you are authorizing the purchase of tickets in the amount listed above. You are also confirming that if you are not the card holder listed, you have the consent and proper authorization of the cardholder to use their credit card for the purpose of this transaction. In order to proceed with your purchase you will need a valid Manitoba address and you must check the above authorization. If these conditions are not met the purchase button will not appear.CommentsThis field is for validation purposes and should be left unchanged.