Print this Page to Order by Mail
Upon receiving
your order, we will complete the ticket stubs with the name, address and phone
number on your order and mail you your official ticket(s) along with a receipt
of payment.
Mail this order form to Batavia Rotary Corvette Raffle, P.O. Box 347, Batavia NY 14021-0347. If you are paying by check or money order please have it made payable to "Batavia Rotary Memorial Fund". If you would prefer to pay by credit card please provide us with the appropriate information below.
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Name:
________________________________________________ |
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| Address:
______________________________________________ |
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| City:
_________________________________________________ |
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| State:
________________________________________________ |
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| Zip:
__________________________________________________ |
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| Phone:
________________________________________________ |
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| E-mail:
_______________________________________________ |
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| Number
of Tickets at $50 each: ___________________________ |
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Buy 3 tickets and SAVE Number of 3 paks ( 3 tickets each ) at $100: ___________________________ |
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| Credit
Card Number: ____________________________________ (Note - we only accept Visa and Mastercard) |
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| Expiration: ____________________________________________ | ||
Signature: ____________________________________________ I hereby authorize The Batavia Rotary to charge my credit card listed above for the indicated number of tickets at $50 each. |
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