Ticket Order Form for 2018 Honda HR-V 2WD EX CVT Drawing

Tickets $25 each. Buy 4 Get 1 Free!

Complete the form below for your chance to win a 2018 Honda HR-V 2WD EX CVT.
Drawing will take place at the Ultimate Fashion Show on Thursday, April 19, 2018.
Your donation supports the children's programs of the Diabetes Foundation of Mississippi including Camp Kandu- Mississippi's only camp for children with diabetes and their families.

*=Required Field

Contact Information
Order Summary
  • 03/20/18
Credit Card Information
  • Card Type
  • MMYY

  • [What is the Card ID?]