2012 YMCA Easter House Mail In Entry Order Form

Name:
Address:
City, State Zip:
Phone:
Email:


Yes, I would like YMCA Easter House Tickets for $
(suggested donation is $10 per ticket plus .50 shipping and handling fee. Example:12 tickets - $120.50 )		    
Buy three(3) Easter House tickets at the same time and get one(1) Free 2nd Prize ticket
 $31.00
Buy six(6) Easter House tickets at the same time and get two(2) Free 2nd Prize Tickets OR 1 Free Easter House ticket $61.00
Buy ten(10) Easter House tickets at the same time and get one(1) Free Easter House ticket and one(1) Free 2nd Prize ticket OR three(3) Free 2nd Prize tickets

$101.00

Buy twelve(12) Easter House tickets at the same time and get two(2) Free Easter House tickets OR four(4) Free Second Prize tickets $121.00
Buy twenty(20) Easter House tickets at the same time and get five(5) Free Easter House tickets AND one(1) Free Second Prize ticket $201.00
Buy twenty(25) Easter House tickets at the same time and get seven(7) Free Easter House tickets AND three(3) Free Second Prize ticket $251.00

I have enclosed a check in the amount of
Make checks payable to YMCA Easter House
  
Please print and mail this completed order form to:
Please charge my credit card:
Card Type:
Card No:    
Exp Date:
CVV:   What is CVV?

Signature: _________________________________________

 YMCA Easter House
1700 SE Monterey Blvd
Stuart, FL 34996-4109