Grand Raffle Ticket Order
*Credit card orders will incurr a 3% credit card processing fee.
First Name:
Last Name:
Address 1:
Address 2:
City: State: Zip:
Phone:
Email:
I am interested in purchasing: ---1 - $25.752 - $51.503 - $77.254- $103 + Free5 - $128.756 - $154.507 - $180.258 - $206 + 2-Free9 - $231.7510 - $257.5011 - $283.2512 $309+ 3-Free13 - $334.7514 - $360.5015 - $386.2516 $412 + 4-Free17 - $437.7518 - $463.5019 - $489.2520 + $515 5-Free tickets
Please select one: Select OneI certify that I am a resident of Elk Grove Village or that I will physically pick up my ticket from Queen of the Rosary School in Elk Grove Village.Please send my ticket(s) home with the person listed below who is a student at Queen of the Rosary School in Elk Grove Village.
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: -----123456789101112 / ----201720182019202020212022202320242025
CVC Code:
Billing Zip Code:
Confirm Ticket Quantity & Total Price with Processing Fee
I understand and approve a 3% 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.