Football Pool | St. Landry-Evangeline United Way

Enter the number of squares you are purchasing. The cost per spot is ($50+$1.50 processing fee) = $51.50 per spot.

Squares Purchased *

$51.50

Total Amount

Donor Information

First Name *

Last Name *

Email Address *

Cell Phone

Street Address

City

State

Zip Code

Credit Card

Card Type

Card Number

Security Code

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *