SWEEPSTAKES TICKET ORDER FORM

Special Olympics Ohio is teaming up with the Knights of Columbus to bring you this unique opportunity to raise funds by making a small donation and possibly winning some prizes so we can continue to make a difference in the lives of our clients.

Please complete the information below. This is for CREDIT or DEBIT card transactions only. All transaction will be processed by PAYPAL and will show up on your statement as KOFC OHIO. Each ticket is a $20.00 donation.

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Select Region (Click for Regional Map) *

Northwest

Northeast

South Central

Southwest

NW: Select County *

NE: Select County *

SC: Select County *

SW: Select County *

Explain Other

Enter the # of Tickets to Purchase *

Ticket Cost (EA) *

Order Total

0.00