Classic Car Draw 2023 - 24

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