pdf of flyer/form - Medical Supplies Network, Inc.

2017 Mercedes-Benz CLA or GLA Class
Choose between one of two luxury vehicles as your GRAND PRIZE.
See these or similar cars at Jackie Cooper Imports, 93rd & Memorial, Tulsa OK.
Drawing to be held October 21, 2016 at the Rotary 6110 District Conference
in Branson Missouri • Call 918.639.1492 for more information
Last year’s
raffle winner
was the
Rotary Club
of Rogers
Early Risers,
Rogers AR
Win your
choice of
a CLA or
GLA Class
Mercedes
Need not be
present to win.
All taxes & title are
responsibility of
winner. Must be at
least 18 years old.
Proceeds go to a 501 (c) (3)
non-profit organization:
Rotary District 6110
Medical Supplies
Network, Inc. (MSNI)
Call 918.639.1492
for more information
$25 – One Ticket • For more chances to win buy 5 tickets for $100
-------------------------------------------------------------------------Mercedes Raffle Ticket Order Form
I would like to purchase:
One Ticket for $25
Five Tickets for $100
More than Five Tickets _________
Total Enclosed $___________
Name:
Address:
City:
Phone:
State:
Zip:
Email:
Mercedes Raffle
MSNI
1123 South Erie Ave.
Tulsa, OK 74112-5307
c
Check enclosed Please make checks payable to MSNI Car Raffle
Please charge my Visa or Mastercard
Account Number
Exp Date
Signature
CSV