Big 5 Raffle Ticket Request Form
Drawing Date is May 7, 2022
Need not be present to win
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,
Thank you for providing valuable resources to our community and the world!
Rotary Club of Sebastopol Foundation, Inc. Tax ID 47-4312102