Draw down Order All proceeds from the Draw Down go to the Mississippi Academy of Family Physicians Foundation. The Draw Down will be held Tuesday, July 21, 2020, at 6 pm and you do NOT have to be present to win. Please complete the form below to purchase your ticket(s). Draw Down Ticket Order Name First Last Cell*(For MAFP use only) E-mail* Draw Down Ticket Quantity Price: $100.00 Quantity Ticket only.Draw Down Ticket With Insurance Quantity Price: $125.00 Quantity Purchasing insurance means if your ticket is one of the first 50 drawn, it will be returned to the Draw Down barrel for a second chance.If I win, I would like to donate to the MAFP Foundation:* Yes No Amount to DonatePlease type in the amount or percent you would like to donate. Draw Down Preferences*If you have purchased a Draw Down ticket, please choose as many boxes below as you wish: If my name is one of the last 4 names, & the other 3 names agree, I wish to split the $10,000 four ways, winning $2,500. If my name is one of the last 3 names, & the other 2 names agree, I wish to split the $10,000 three ways, winning $3,333. If my name is one of the last 2 names, & the other 1 name agrees, I wish to split the $10,000 two ways, winning $5,000. I do NOT wish to split at any level. PAYMENT INFORMATIONTOTAL DUE $0.00 Method of Payment* Check Credit Card Tickets must be paid before they are issued to the buyer.NameThis field is for validation purposes and should be left unchanged. Δ
