Mega Millions® with Megaplier ®
Subscription Form
Please print clearly. Complete this subscription form or call us weekdays between 7:00 a.m. and 3:30 p.m. at 1 800-752-9568. We will mail you
a confirmation with your choices and effective date along with your Illinois Lottery Subscription card. As soon as you receive your card, be sure
to register it at illinoislottery.com so your winnings can be placed on your card. You may receive your confirmation after your subscription has
gone into effect. The odds of winning MEGA MILLIONS can be found at any time by visiting our Web site at illinoislottery.com.
Note: Completion of this subscription form certifies each purchaser or gift recipient is 18 years of age or older.
Step 1: Provide the subscriber information. - -
Last name: First: Middle initial: Social Security Number:
/ /
Street address: Apartment/Suite:
Date of Birth:
City: State: Illinois ZIP code: ( ) -
Telephone - Include Area Code:
Email address:
Step 2: Complete this step only if you are giving this subscription as a gift. Recipient must be at least 18 or older.
Last name: First: Middle initial:
/ /
Street address: Apartment/Suite: Date of Birth:
City: State: ZIP code: ( ) -
Telephone - Include Area Code:
Message: Limited to 24 Characters
Step 3: Pick your plan. Check one box only. There are 2 drawings per week – Tuesday and Friday.
You get 1 game per $1 played per drawing. Subscribe for 26 weeks and receive 1 week free. Subscribe for 52 weeks and get 2 weeks free!
13 weeks (26 draws) 26 weeks (52 draws) 52 weeks (104 draws)
1 game = $26 1 game = $52 $50 1 game = $104 $100
2 games = $52 2 games = $104 $100 2 games = $208 $200
3 games = $78 3 games = $156 $150 3 games = $312 $300
4 games = $104 4 games = $208 $200 4 games = $416 $400
5 games = $130 5 games = $260 $250 5 games = $520 $500
MEGAPLIER! Win 2, 3, or 4 times the prize (except the jackpot) with MEGAPLIER and the Match 5 prize is always $1 million!
MEGAPLIER doubles the cost of your subscription. Check here to add MEGAPLIER:
Step 4: Select how you want to play. Check one.
Quick Pick (Computer will randomly select for you) Circle your own (If too many numbers are circled, your subscription will be rejected.)
Game 1 Game 2 Game 3 Game 4 Game 5
Circle 5 or Quick Pick Circle 5 or Quick Pick Circle 5 or Quick Pick Circle 5 or Quick Pick Circle 5 or Quick Pick
01 02 03 04 05 06 07 01 02 03 04 05 06 07 01 02 03 04 05 06 07 01 02 03 04 05 06 07 01 02 03 04 05 06 07
08 09 10 11 12 13 14 08 09 10 11 12 13 14 08 09 10 11 12 13 14 08 09 10 11 12 13 14 08 09 10 11 12 13 14
15 16 17 18 19 20 21 15 16 17 18 19 20 21 15 16 17 18 19 20 21 15 16 17 18 19 20 21 15 16 17 18 19 20 21
22 23 24 25 26 27 28 22 23 24 25 26 27 28 22 23 24 25 26 27 28 22 23 24 25 26 27 28 22 23 24 25 26 27 28
29 30 31 32 33 34 35 29 30 31 32 33 34 35 29 30 31 32 33 34 35 29 30 31 32 33 34 35 29 30 31 32 33 34 35
36 37 38 39 40 41 42 36 37 38 39 40 41 42 36 37 38 39 40 41 42 36 37 38 39 40 41 42 36 37 38 39 40 41 42
43 44 45 46 47 48 49 43 44 45 46 47 48 49 43 44 45 46 47 48 49 43 44 45 46 47 48 49 43 44 45 46 47 48 49
50 51 52 53 54 55 56 50 51 52 53 54 55 56 50 51 52 53 54 55 56 50 51 52 53 54 55 56 50 51 52 53 54 55 56
Mega Ball Mega Ball Mega Ball Mega Ball Mega Ball
Circle 1 or Quick Pick Circle 1 or Quick Pick Circle 1 or Quick Pick Circle 1 or Quick Pick Circle 1 or Quick Pick
01 02 03 04 05 06 01 02 03 04 05 06 01 02 03 04 05 06 01 02 03 04 05 06 01 02 03 04 05 06
07 08 09 10 11 12 07 08 09 10 11 12 07 08 09 10 11 12 07 08 09 10 11 12 07 08 09 10 11 12
13 14 15 16 17 18 13 14 15 16 17 18 13 14 15 16 17 18 13 14 15 16 17 18 13 14 15 16 17 18
19 20 21 22 23 24 19 20 21 22 23 24 19 20 21 22 23 24 19 20 21 22 23 24 19 20 21 22 23 24
25 26 27 28 29 30 25 26 27 28 29 30 25 26 27 28 29 30 25 26 27 28 29 30 25 26 27 28 29 30
31 32 33 34 35 36 31 32 33 34 35 36 31 32 33 34 35 36 31 32 33 34 35 36 31 32 33 34 35 36
37 38 39 40 41 42 37 38 39 40 41 42 37 38 39 40 41 42 37 38 39 40 41 42 37 38 39 40 41 42
43 44 45 46 43 44 45 46 43 44 45 46 43 44 45 46 43 44 45 46
Step 5: Make your payment – Do not send cash. You must pay the exact amount – no refunds will be issued.
Card-Check type: AMEX Discover MasterCard VISA Account Number:
Expiration: / / Your signature: Date: / /
Check or money order. Make Payable to “Illinois Lottery”.
Mail your subscription and payment (if applicable) to the Illinois Lottery Subscriptions, PO Box 19081, Springfield, Illinois 62794-9081. If you are
paying by credit card, you may fax this subscription to us at 217 524-5190 or mail it to us at the address above.
Play responsibly. Must be 18 or older to play. If you or someone you know has a gambling problem, crisis counseling and referral services can be accessed by calling 1-800-GAMBLER (1-800-426-2537). For more info or to
exclude yourself call 1-800-252-1775 or visit illinoislottery.com.