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Only submit this form AFTER you have placed an order. Please go here to place your order first.

Order Number: * If you have not placed an order, please do so before submitting this form.

Is This Basket Raffle ?
YesNo

Name of Raffle: *

Desired Raffle Website URL:

.OurRaffle.org
Max 25 Char, Must start with a letter

Raffle Description: *

Ticket Packages:

1 ticket: $*

add another options?
YesNo

Nr of Tickets

Amount

Nr of Tickets

Amount

Nr of Tickets

Amount

Raffle Rules: *

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Raffle Start Date: *

Raffle Start Time: *

Raffle End Date: *

Raffle End Time: *

Time Zone: *

What payment gateway do you want for cc?*

Do you want to charge a service free?
YesNo

What Percent would you like to charge?

Do you want Chance2Win to choose your winners?
YesNo

Date and Time for drawing to happen:

Charity Name: *

Charity Contact:

Charity description: *

Charity Address: *

Charity Phone: *

Charity email: *

Charity Website:

Charity Facebook:

Charity Instagram :

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Any other information you want us to know when setting up your raffle?

* required fields