Town Computer's Community Partnership Program

Computer Training Raffle

 

Complete this form to purchase raffle tickets for a chance to win a brand new computer system, complete with a 19" flat screen monitor. The second prize is an all-in-one printer.  The drawing will be held on September 30, 2007.

* All proceeds will be used to purchase equipment and software for the computer training program. 

 

Please provide the following contact information:

First Name
Last Name
Address
Apt
City
State
Zip Code
Home Phone
E-mail

Please provide the following ordering information:

BILLING
Credit Card
Cardholder Name
Card Number
Expiration Date
Security Code (3-digit code found on rear of card)

Billing Address
Address
Apt
City
State
Zip Code

Select the number of raffle tickets you wish to purchase (keep in mind that each raffle ticket costs $15):

1
2
3
4
5
6
7
8
9
10

** By clicking submit, I agree that my credit/ debit card will be charged $15 for each raffle ticket.  

 

Town Computer.
Copyright © 2007 [TownComputer]. All rights reserved.
Revised: December 06, 2008