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Big 5 Raffle Ticket Request Form
 
Drawing Date is May 7, 2022
Need not be present to win
Name:
 
Address:
 
Phone:
 
Email Address:
 
Rotarian Contact (if known):
 
# Of Tickets ($50 for 1, or 5 for $200,
or 30 for $1000)
 
Payment Method:
Circle one:     Visa    MasterCard     Check       Cash
Credit Card #:
 
CC Expiration Date:
 
CC Security Code:
 
CC Zip Code:
 
 
Checks to be made out to:  Rotary Club of Sebastopol Foundation
Please complete this form and email, mail, or deliver to your Rotary Club of Sebastopol contact or Kelly Back at Exchange Bank, Sebastopol (707) 823-4087
Rotary Club of Sebastopol, PO Box 213, Sebastopol, CA 95473
Questions? Contact your Rotarian contact or Hal (202) 262-2139 or
Kelly at Exchange Bank (707) 823-4087, Kelly.Back@exchangebank.com
 
Thank you for providing valuable resources to our community and the world!
Rotary Club of Sebastopol Foundation, Inc. Tax ID 47-4312102
Sponsors