Warren Mott Boosters Reverse Raffle Order Form

Drawing April 2, 2003

7pm until 11pm

Tickets $55 each

Make checks payable to:
Warren Mott Boosters Club

Mail to:
Warren Mott High School
Attn: Boosters Raffle
3131 Twelve Mile Rd
Warren, MI 48092

Name:______________________________________________

Address:____________________________________________

City, State, Zip: _____________________________________

Phone (include area code): ____________________________

Alternate phone: _____________________________________

If you are not in attendance and we cannot contact you during the drawing,
and you are one of the last 2 tickets in the drum,
would you like to split the top 2 prizes ?

Remember, BOTH PARTIES must agree to split

SPLIT ?

YES NO