Central Alberta Humane Society Lottery

1 Information

This serves as both your billing and shipping information. If you wish to ship to another location, please Contact Us.

First Name

Last Name

Email Address

Phone Number

Alt Phone Number

Confirm Email Address

Address

Postal Code

City

Province *Tickets only available in Alberta

Country

Is this a gift?

First Name

Last Name

Phone Number

Alt Phone Number

Address

Postal Code

City

Province

Country

Shipping Instructions

Please be aware that the address information above is used as your billing information, please make sure it matches your card information.

Sorry American Express is not currently accepted. Please try either Visa or Mastercard.

Credit Card Information

Month

Year

CVV

Item	Quantity	Price
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