APAV Bike Raffle Ticket Purchase Form

Help us help the Animals...

And WIN PRIZES!!!
NOTE: Once you submit your ticket purchase, BE SURE TO SAVE YOUR EMAIL THAT YOU RECEIVE. THAT IS YOUR ENTRY TICKET THAT YOU WILL NEED TO PICK YOUR PRIZE UP.

We will collect the emails we receive and that is what we will use for the drawing. The drawing will be a live drawing on our Facebook Page on April 22nd.
Full Name *

Prefix First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
We need your phone number to call you to let you know if you won.
Phone Number: We need your phone number to let you know if you won.
BIKE RAFFLE
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Ticket Price $ 10.00

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Help us help the Animals...