Congratulations Lois Lane!

Your Account ID is 0123456789.

Please write this information down for future access to our site.

You are entitled to a discount!

Purchase a plan this week for 20% off of the regular price.

Your discount is valid until

October 30, 2006!

Plan

Please select a plan from the options below.

Plan Duration Regular Price Your Price
Individual
Your application for 1 year
1 Year $69 $49
Individual
50% discount on 2nd year!
2 Years $89 $69
Individual
Best Value: Free Year!
4 Years $139 $119
Couple
You and Your Spouse - Double Your Chances!
1 Year $99 $79
Couple
70% discount on 2nd year!
2 Years $119 $99
Couple
Best Value: Free Year!
4 Years $219 $199
Life Time Application - Until You Win!
We submit you and your family every year until you win!
$549 $499

Payment

Please select a payment plan. Credit Card and PayPal are highly recommended.

Credit Card PayPal Western Union Cashiers Check Cash
PayPal PayPal Western Union Cashiers Check Cash

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Western Union

Applicant Name Lois Lane
Account Number 0123456789
Payment Plan Couple 1 Year
Amount to Send $99

General Instructions

Western Union is an easy and safe way to send cash payments. There are tens of thousands of Western Union agents in almost every country around the world. To locate a Western Union agent in your area, go to www.payment-solutions.com/agent.asp.

You must use a Western Union location that is able to make "QuickPay / QuickCollect" transfers.

Take this form to the nearest Western Union location (please check http://www.payment-solutions.com/agent.asp to make sure that this location is able to make "QuickPay" payments before you go). Request a QuickPay / QuicikCollect form (see sample form below).

0123456789

Western Union Form Instructions

PAY TO section

  • In the COMPANY NAME, fill in: TBD
  • In the COMPANY CODE line, fill in: TBD
  • In the COUNTRY line fill in: USA

SENDER section

  • Fill in all your personal information
  • In the ACCOUNT NUMBER line fill in your registration number: 0123456789
  • Sign the form

ALMOST DONE...just two more steps

  • Be sure to receive a confirmation number (called a Money Transfer Control Number or "MTCN") for your payment from the Western Union agent. Enter this number below, and keep it in a safe place.

    Money Transfer Control Number: ________________________________________

  • Email USA Greencard Lottery at [email protected] using the subject Western Union Payment. Make sure to include your Account Number (0123456789) and the Western Union Money Transfer Control Number (MTCN#) for your payment from the Western Union agent.
 
  • If the user selects a Province or State, then the options of the Country menu should dynamically udpate such that only Canada and the United States of America are options.
  • If the user first selects a country other than Canada and the United States, then the Province or State menu should be disabled.