Grand Raffle Ticket Order Form

Grand Raffle Ticket Order Form

Grand Raffle Ticket Order

*Credit card orders will incurr a 3.9% credit card processing fee.

First Name: 

Last Name: 

Address 1: 

Address 2: 

City:   State:   Zip: 

Phone: 

Email: 

I am interested in purchasing:   tickets

Please select one:  

 Student Name if Applicable

 Instead of purchasing a ticket (or in addition to my ticket order selected above) I would like to make a donation to Queen of the Rosary School in the amount of:  

All sales are deemed to occur within Elk Grove Village and in accordance with all legal requirements and are subject to the terms and conditions contained herein:  Grand Raffle Rules & Regulations

 I have read, understand and accept the Grand Raffle Rules & Regulations

Billing Information:

Credit Card Number: 

Experation Date:  / 

CVC Code: 

Billing Zip Code: 

Confirm Ticket Quantity & Total Price with Processing Fee

I understand and approve a 3.9% credit card processing fee that will be added to my total.

I authorize Queen of the Rosary to charge my credit card.

   *Without this authorization Queen of the Rosary cannot process your order.



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