Stein Hospice Sporting Clay Shoot Raffle Ticket Information: $20.00 per ticket OR 3 for $50.00 Will be drawn at the event this year on Sunday, July 14, 2019. Prizes: TBD All proceeds benefit Stein Hospice. For more information call Stein Hospice at 800.625.5269. Raffle Tickets Number of Tickets: No Tickets Single Ticket (20.00) 3 Tickets (50.00) Registration Information First Name: Last Name: Street Address: City: State: Choose One ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENV NHNJNMNYNCND OHOKORPARISCSDTNTXUTVTVAWAWVWIWYOther Zip Code: Phone Number: Email Address: Use this address for billing: Billing Information First Name: Last Name: Billing Street Address: Billing City: Billing State: Choose One ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENV NHNJNMNYNCND OHOKORPARISCSDTNTXUTVTVAWAWVWIWYOther Billing Zip Code: Billing Phone Number: Billing Email Address: ? An email address is needed to send a receipt to. We will not use your email address for anything else. Credit Card Information Card Type: Choose One VISA MasterCard Discover American Express Account Number: Expiration Month / Year 01 02 03 04 05 06 07 08 09 10 11 12 2018201920202021202220232024202520262027202820292030 CVV Code from back of card: Please fill all required fields.