2026 Life Membership Raffle
Please complete all contact and payment information. Names are submitted upon completion of payment. Only ONE entry per Brother.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Current Chapter
*
Current City
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Please select your state
*
Alabama
Georgia
Florida
Mississippi
Control #
*
Ticket Portal
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1 Raffle Ticket
$10.00
$
10.00
Quantity
1
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10
Submit
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