Raffle Ticket
 Order Form

Name:

Street:

City:

State:

Phone:

Number of Tickets Purchasing

How Many:

X    $100 per ticket       =

$

Method of Payment

(Please check)

Cash:

Check:

Charge*:

*Charge Information

MasterCard/ Visa    Number:

Expiration Date:

Signature:

Where to Send Your Order

Mail:

St. Walter School

201 W. Maple Avenue

Roselle, IL 60172

Fax:

630-529-9290

To Request Tickets or To Have Us Call You

E-mail:

alumni@ stwalterschool.com

For Phone Orders

Call:

630-529-1721