YMCA First Annual $10,000 giveaway
Ticket Order form

Tickets are $25 each.  To order: Print this form, fill it out and mail it with your
check, money order or credit card information to:

Lincoln Area YMCA
319 W. Kickapoo
Lincoln, IL  62656
217-735-3915

Name:__________________________________________________

Street Address:___________________________________________

City________________________   State:______   Zip:____________

Phone:__________________________________________________

Payment type (Circle one):         Check         Money Order        VISA / MC

Number:____________________________    Exp. Date:__________

Signature:_______________________________________________

Or click here to order online.
**NOTE** Credit card orders must be made on paper.