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Thank you for purchasing your chance at

$100,000!

Registration Form

Package Name	Amount	Quantity	Subtotal

Individual Ticket	$100.00		$0.00

Additional Donation Amount:

Online Convenience Fee:

4.00%

Total:

$0.00

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	Name	Role	Email	Telephone	Telephone 2
	RCHS OSS Dreams Office		rchsossdreams@gmail.com	217 243-1632

2nd Prize

$40,000 Cash!

Money Stacks Wallpaper

Earlybird Prize

$10,000 Cash!