$2010 Prize Raffle
Sponsored by
Polish American Cultural Center Museum
308 Walnut Street • Philadelphia, PA 19106
(215) 922-1700 • Internet: PolishAmericanCenter.org

Drawing will take place on Thursday, April 15, 2010
3 P.M. in the Museum Exhibit Hall

Proceeds Benefit Museum and Cultural Programs
Donation $10.00 - Winner need not be present

Complete the below ticket order form and return it with your remittance.

Polish American Cultural Center
$2010 Prize Raffle Request Form

Kindly send me (____) raffle ticket(s) at $10 per ticket to:


Name _____________________________________________________

Address ___________________________________________________

City ________________________ State _________ Zip _____________


Make your check payable to:
Polish American Cultural Center


I have enclosed $ ________ for the ticket(s).

Upon receipt of your remittance, the ticket stub(s) will be completed with the above information and your portion of the stub will be mailed to you for your records.

Mail this form with your remittance to:

Polish American Cultural Center
308 Walnut Street
Philadelphia, PA 19106
Telephone: (215) 922-1700