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hcjacksontripbutton.jpg (5794 bytes) Mail to:
YMCA of the Blue Water Area
700 Fort St.
Port Huron, MI 48060


 
 

     

Name: ______________________________________________

Address: ____________________________________________

City: _______________________________________________

State/Province: _____________________________

Postal Code: _______________________________

Country:______________

Phone: (___)___________

Amount Enclosed: ___________ tickets are $20.00 (U.S.) each

Number of tickets: ______


Your ticket(s) will be promptly mailed to you.
Drawing will be held on December 1, 2000. Winner need not be present at drawing to win.


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