(To print this form, click the "Print" button on your Web Browser)

Mail a self addressed, stamped envelop to:
St. Clair Rotary Club
PO Box 441
St. Clair, MI 48079

Make checks payable to: St Clair Rotary

 The drawing will be held September 30, 2017 at the St Clair River Park on Riverside Avenue, St. Clair, MI.

Name: ______________________________________________

Address: ____________________________________________

City: _______________________________________________

State/Province: _____________________________

Postal Code: _______________________________


Phone: (___)___________

Number of tickets: ___________ tickets are $10.00 (U.S.) each

Amount Enclosed: ___________

State of Michigan License # R41383

Return to Great Lakes & Seaway Shipping    www.BoatNerd.Com