First Name

Last Name

Company

Email

Phone Number

Choose only one category

1 2 3 4 5 6 7 8 9 10  packet of 5  Raffle ticket  5 for $20

Method of Payment

(Credit Card registrations will be redirected to the processing page).

Additional Information or Comets:

Proceeds fund the NMUCA Scholarship Program 

Please note that tickets will be filled out and entered into the drawing. A picture of the tickets filled out will be emailed to the recipient. 

For more information
Email: jane.nmuca@gmail.com
Web: www.nmuca.org

Make checks payable to NMUCA. Send completed form with payment to: NMUCA PO Box 90847 Albuquerque, NM 87199. FAX 505 341 0191