Name:
Mailing Address:
City, State &
Zip Code
Phone Number::
Email Address:
Number of Tickets Requested:
Comments:
purchase 5 raffle tickets at
$3.00 each.
                 $15.00
purchase 10 raffle tickets at
$3.00 each.
               $30.00
purchase 20 raffle tickets at
$3.00 each.
               $60.00
purchase 33 raffle tickets at
$3.00 each.
               $99.00
Complete the information below and submit.  We will complete your order and
send you an invoice by email. Confirm the information, then click the PAY NOW
button, and you will receive your Raffle Tickets within ten working days.
PAY WITH PayPal
Other Payment Options
To Pay with Visa, Master Card or other methods:
* Return completed stubbs no later than Feb.15, 2012
to: L.B. McGill
     2347 Broadgreen Dr.
    Missouri City, TX  77489
    PH(281) 261-4903