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Win a car!!! Omega Radio
Complete the form below to receive your ticket numbers and confirmation and then click the following link to pay:
https://checkout.square.site/buy/7ARERHXED27GIDMTI7CYOVJ7
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Name
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Your answer
Phone number (will use this to send confirmation)
*
Your answer
Email
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Your answer
Amount of Tickets/Entries Bought
*
One Entry/Ticket ($50)
Two Entries/Tickets ($75)
Special VIP: Three Entries/Tickets ($100)
Other
Required
If answered other to above question, how many tickets/entries were purchased?
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Date Payment Was Made
*
Your answer
Name Used When Payment Was Made
*
Your answer
Amount of Payment Made
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Your answer
PAY NOW! Pay and then submit form.
https://checkout.square.site/buy/7ARERHXED27GIDMTI7CYOVJ7
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