When you submit this form, your inquiry will be forwarded to the organization from which you received your game card. Your contact information is necessary to help the organization resolve your inquiry. Items with a “ * “ are required.

Ticket or Game Card # *
-      
Your Name *  
Street Address
Street Address 2
City
State, Zip ,
Phone Number *  
Email Address *  
Seller (explain this)
Message to Seller
Your contact information is kept strictly confidential and will not be used for any purpose other than those stated explicitly on this page.  See our privacy policy if you would like more details.