1. No category

2015 HAVANESE RESCUE QUILT—FREE DRAWING ENTRY
Please use this form to register for and donate to our Havanese Rescue Quilt Raffle if
paying by check. (If paying by PayPal, just click on the link for that option on the
Havanese Rescue, Inc. website and you’ll be asked for the necessary information.)
Anyone and everyone who enters will receive one FREE ticket which is entered in the
drawing! After the first entry, we are requesting a $5.00 donation for each additional
ticket. Please refer to the table on the next page to determine how many tickets to
send in for your donation amount. Note: All tickets will automatically be filled in and submitted on your behalf once
we receive your check and this filled-out form.
Please note that all mail-in donations must be received by Saturday, August 1, 2015 to be entered in the drawing.
After that, tickets may be purchased at the Havanese National Specialty starting on August 11 at the Westin Lombard
Hotel, 70 Yorktown Center, Lombard, IL 60148, United States. The actual drawing will be held on August 15. No
purchase is necessary to win. All proceeds will benefit Havanese Rescue, Inc. The winner need not be present to win. If
the winner is not present, notification will be made by email or phone on or before August 16, 2015.
We need to have you fill out ALL the information requested below:
For my FREE ticket, I’m entering to win (choose one):
Quilt “A” The HRI Quilt “Favorite Things”
●
Quilt “B” The Havanese Quilter’s Quilt “Star of the Show“
NOTE: Please be sure to check a box to indicate which quilt you want to win (A or B). Entries without this designation will be placed
randomly in one of the drawings at the discretion of HRI.
I would like the following additional tickets for a $5.00 donation each:
# of Tickets:
Quilt(s) Selected:
Quilt “A” The HRI Quilt “Favorite Things”
Quilt “B” The Havanese Quilter’s Quilt “Star of the Show“
Total # of Tickets
Donation Amount Due (Total # of Tickets x $5.00 each)
Please make checks payable to: Havanese Rescue, Inc. Mail with this form filled out to:
HRI Quilts
c/o Lori Brostrom
710 Summit Avenue, Apt. 1
St. Paul, MN 55105
First and Last Name:
Email:
Phone:
Address:
City, State, Zipcode:
Donation Amount
# of Entries
$0
1
$5
2
$10
3
$15
4
$20
5
$25
6
$30
7
$35
8
$40
9
$45
10
$50
11
$55
12
$60
13
$65
14
$70
15
$75
16
$80
17
$85
18
$90
19
$95
20
$100
21
Please add a $5 donation for each additional ticket.