LEAVES OF CLASS
Please complete this form to process your payment.
Your presence is not required at monthly drawings.
A limited number of chances will be sold.
The drawing will begin on
31 January 2012 and continue through 31 December 2012.
|Personal Information: (* Required Field)|
|*Area Code / *Home Phone #:|
|*Area Code / *Cell/Work Phone #:|
|Ticket Order||Quantity Price||Total|
|Number of Tickets||x $20 = $|
|Grand Total: $|
|* Method of Payment:|
|Gift envelopes available by calling 570-941-7816|
I would like to receive email notification about future Library events.