Instructions:

  1. Fill in each field in the form below. 

  2. Verify the information

  3. Click on Submit when finished.

    1. This will take you to the PayPal page​

    2. And send us the information.

  4. You will receive a success or an error message when you submit the form.  If you get an "error" message, refresh the page and try again.  All fields are required to be filled.

  5. A copy of your ticket will be texted or e-mailed to you.

  6. A live drawing will be held on Facebook.

First Name:

Last Name:

Street Address

City:

State:

Zip Code:

Phone:

E-mail Address:

Quantity of Tickets

x $50

Thank you for helping to support the Lions Club activities in La Farge!

Title 10 Motor Vehicles and Traffic

Chapter 1 Traffic and Parking

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