Operation Kirkland, Part 2 - The Raffle

 

 

Righ-Click to  print this handy-dandy form to enter the raffle!

 

 

 

 

Name:                          ­­­­­­­­­­­­­­­­­­­­___________________________________

 

 

 

Email Address:                        ___________________________________

 

 

 

 

 

 

Name to publish online if you win

(if you prefer to use a name other than your ‘real’ name):             _________________________

 

 

 

 

Number of raffle tickets you wish to purchase*:                   ____________

 

·         $10 for 1 ticket 

·         $20 for 3 tickets

·         $25 for 5 tickets

·         All tickets after $25 are $5 ea.

 

 

Total amount enclosed:                                    $_____________

 

 

 

Please make checks or money orders payable to:

Pediatric Heart Transplant Foundation

 

Write in the memo space:

c/o Cody Kirkland Fund

 

 

 

Mail your payment with this form (or reasonable facsimile) to:

Pediatric Heart Transplant Foundation
c/o Cody Kirkland Fund
1950 Rudy Road
Harrisburg, PA 17104

 

 

 

 

 

 

*Must be 18 years old or older to purchase. Void where prohibited. See instructions and fine print for additional details and requirements.

 

 

 

 

 

 

 

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