Belz Kollel of Antwerp – 100ksweepstakes.com

Currency*
- EUR
- USD
Sweepstakes Ticket Package*
- 85 Donation
  - - 1 entry into the $100,000 Grand Prize
  - - 1 entry into each of the additional prizes
- 45 Donation
  - - 1 entry to win $50,000 Prize
  - - 1 entry into $5,000 or 4 tickets to Israel
  - - 1 entry into $2,000 visa gift card
  - - 1 entry into $1,000 at Focus Camera
  - - 1 entry into $1,000 Toys Gift Certificate
- 25 Donation
  - - 1 entry to win $25,000 Prize
  - - 1 entry into $5,000 or 4 tickets to Israel
  - - 1 entry into $2,000 visa gift card
  - - 1 entry into $1,000 at Focus Camera
  - - 1 entry into $1,000 Toys Gift Certificate
- Other Amount
Other Amount
PERSONAL INFORMATION*
First name Last name
- please display my name differently on the scroll.
- Display my name as anonymous
Please display my name as
ADD PERSONALIZED MESSAGE
Please credit my donation
- In Memory Of
- In Honor Of
- Refuah Shleima for
- As a Z'chus for
Scroll comment
Email*
Phone*
Coupon
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Credit Card
Card Details
Cardholder Name
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Additional Notes:
Total:
$0.00
Comments
This field is for validation purposes and should be left unchanged.