Online Holiday Raffle Form Holiday Basket Raffle Name * Name First First Last Last Address * Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Email * Phone * We will be holding a raffle at our Holiday Celebration. Raffle tickets are $5.00 each, or 3/$10.00. If you are choosing to put more than 1 ticket on a basket, please use the additional baskets option and list which additional baskets you are choosing. There is also an additional notes line, if needed. How many individual tickets are you buying? * Raffle tickets are $5.00 each How many books of 3 tickets are you buying? * Each book of 3 tickets is $10.00 Total of purchase Raffle Basket Choices * Handmade Basket Tough Traveler Backpack $100.00 King Arthur Gift Card with Cookie Jar Stained Glass Handmade wooden bowl Honey Bee Gifts including honey Kitchen Composter Additional basket choicesAdditional basket choices Additional notesAdditional notes If you are human, leave this field blank. Submit
