Please do not use a debit card as we are unable to process them
Name _____________________________________________________
Address ____________________________________________________
City ________________________________________________________
Prov/State __________________ Postal Code/ZIP ___________________
Telephone (home) ________________ Telephone (cell) _________________
Email address _________________________________________________
Number of tickets requested _______________ Amount to be charged $______
Payment type Cheque ______ Money Order _______
CREDIT CARD INFORMATION
VISA _______ MASTERCARD ________ AMEX ________
CARD NUMBER ______________________________________________
EXPIRY DATE ________________ V CODE ________________________
(MONTH / YEAR) (BACK OF CARD)
Check for email ______ Check for Canada Post _______
Tickets are $5.00 each, 5 tickets for $20.00, or 15 tickets for $50.00
To order your tickets, please print this page, complete it and send it along with your payment by cheque, money order or credit card to
Classic Car Draw
Rotary Club of Fenelon Falls
P.O. Box 862
Fenelon Falls, Ontario
K0M 1N0
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