Lotto Pool Order Form
Pool Ticket Play: 1 MEGA Million® & 1 SuperLOTTO Plus® = $2 per play
To contact us just fill out this form. Your Name: Your Telephone Number: Your Email Address: Your Street Address: City: State: Zip: Service You Require:(Questions, No. of Plays, etc...) Payment by: Credit Card Check By Mail Your Credit Card Number:  Exp. Date:  (mm/yy) Number of Plays:  Tue/Wed Number of Plays:  Fri/SatTotal Number of Plays:  X Number of Plays @ 2.00= Please contact me by: Email Telephone Mail Checks To:Collin Wilson EnterprisesCA Lotto Pool450 W. Pioneer Drive Suite 441Glendale, CA 91203More Information here
Your Name:
Your Telephone Number:
Your Email Address:
Your Street Address:
City:
State: Zip:
Service You Require:(Questions, No. of Plays, etc...)
Payment by: Credit Card Check By Mail
Your Credit Card Number:  Exp. Date:  (mm/yy)
Number of Plays:  Tue/Wed Number of Plays:  Fri/Sat
Total Number of Plays:  X Number of Plays @ 2.00=
Please contact me by: Email Telephone
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