OFFICIAL RAFFLE ENTRY FORM

OFFICIAL RAFFLE ENTRY FORM. Complete and mail this form to: 3333 Concours St., Bldg. 2, Ste. 2100. Ontario, CA 91764 or fax it to: 951-769-6733 (Attn: Matt ...
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OFFICIAL RAFFLE ENT RY FORM Complete and mail this form to: 3333 Concours St., Bldg. 2, Ste. 2100 Ontario, CA 91764

or fax it to:

951-769-6733 (Attn: Matt Gilson) DO NOT EMAIL

RAFFLE T ICKET ______ Single ticket(s) at $100 each .........................................................................Total Amount: $ _________

T ICKET INFORMAT ION Name To Appear On Ticket:_________________________________ Phone: _______________________ Mailing Address For Ticket: ______________________________________________________________ City: ____________________________________________ State: ________________ Zip:____________ Email: _______________________________________________________________________________

PAYMENT

[ ] Check enclosed – payable to SCPGA Foundation Or, please charge my (check one): [ ] VISA [ ] MasterCard [ ] American Express [ ] Discover Please print legibly so we may process your order without delay: Card #:__________________________________________ Expiration Date: _______ Security #:______ Name On Credit Card:_____________________________ Signature:_____________________________ Email:___________________________________________ Phone: _______________________________ Billing Address: ________________________________________________________________________ City: ____________________________________________ State: ________________ Zip: ____________

YOU MAY ALSO ORDER BY PHONE:

Please call 951-845-4653 and ask for Matt Gilson Your numbered ticket receipt(s) will be mailed to you after your check or credit card is processed ( minimum of 5 business days). The raffle ticket(s) with matching number(s) will be placed in the official drum for the drawings. Orders must be received no later than July 7th, 2016. ALL SALES ARE FINAL! NO REFUNDS! Only 100 tickets will be sold. Must be 18 years or older to enter. Void where prohibited. © 2016 SCPGA Foundation. All Rights Reserved.