2021 Lucky Numbers Entry Form

Name: __________________________________________________________________________________

Address: ________________________________________________________________________________

Phone Number: ________________________ Payment Amount Enclosed: __________

($40 each; one form per entry please)

If available, please select a three digit number: ___ ___ ___

(Select any three digits from 000 to 999; if that number is unavailable another number will be assigned)

It’s easy to play and easy to win!

1. Complete the entry form below.

2. After your entry form is processed, you will receive your Lucky Numbers

and Prize Calendar. Daily prizes start at $45 and increase on Holidays, Holy Days,

and other Bonus Days!

3. Check the nightly lottery for your numbers, And then check your mailbox for your winnings!

Cut along the dotted line and return entry form and payment to: Saint Pius X Rectory 220 Lawrence Road Broomall, PA 19008