Please complete the form below and mail it to the below address with a check or money order.
Thank you!


 
(Print Clearly)
Name: ________________________________
Address: __________________________
City: _________________________
State: _______ Zip Code: _______- _____
Phone: __________________________
Email (optional) ______________________________
Number of tickets: _____ at $10 per ticket or 3/$25 = $ __________  (in US funds)
    
Send form and Check or Money Order to:
Drawing/LSMMA
PO Box 177
Duluth, MN 55801-0177

For more information call: 218-727-2497

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