24th Annual Benefit Gala Raffle Reservation Form
Reserve your raffle ticket today!
$10,000 CASH PRIZE Cost: $100 per ticket Only 300 tickets to be sold Name _________________________________________________________________________________________ Circle any that apply: a) Alumnus/a
b) Business/Vendor
c) Current Parent
d) Past Parent
e) Trustee/Former Trustee
PAYMENT INFORMATION Name ____________________________________________________________________________________________________ Address __________________________________________________________________________________________________ City _______________________________ State ______________________________________ Zip________________________ Telephone ____________________________________
Email __________________________________________________
Enclosed is a check in the amount of $___________ or Please charge my/our credit card in the amount of $ ___________ Circle one: a) Amex b) Discover c) MasterCard d) Visa Name on Card _________________________________________________________ Credit Card # __________________________________________________________ Authorized Signature ___________________________________Expiration Date ____________ Security Code__________
Send your completed raffle reservation form to: Address: Loyola School •Office of Advancement • 980 Park Avenue • New York, NY 10028 Office Phone: 646.346.8135 •Fax: 212.879.4864 •E-mail: rdugan@loyolanyc.org
On behalf of the 2016 Benefit Gala Committee, thank you for your generous participation!