Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.First and Last Name *Phone *Email *Would you like to receive emailed DSE updates?Yes, please subscribe my email for DSE UpdatesAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHow many raffle tickets would you like for yourself? They are $25 each, with a maximum of 10. *Please Select OneNo Raffle Tickets for Myself (Gifting Only) - $0.001 Raffle Ticket - $25.002 Raffle Tickets - $50.003 Raffle Tickets - $75.004 Raffle Tickets - $100.005 Raffle Tickets - $125.006 Raffle Tickets - $150.007 Raffle Tickets - $175.008 Raffle Tickets - $200.009 Raffle Tickets - $225.0010 Raffle Tickets - $250.00Would you like to give raffle tickets as a gift to someone else?NoYesHow many people do you want to gift raffle tickets to? Selected Value: 1 Due to the limitations on this form, if you would like to gift more than 10 recipients, please let us know when we call to collect payment.Gift Recipient #1: Name, Email & Phone Number *How many raffle tickets would you like for Gift Recipient #1? *1 Raffle Ticket - $25.002 Raffle Tickets - $50.003 Raffle Tickets - $75.004 Raffle Tickets - $100.005 Raffle Tickets - $125.006 Raffle Tickets - $150.007 Raffle Tickets - $175.008 Raffle Tickets - $200.009 Raffle Tickets - $225.0010 Raffle Tickets - $250.00They are $25 each, with a maximum of 10 for this recipient.Gift Recipient #2: Name, Email & Phone Number *How many raffle tickets would you like for Gift Recipient #2? *1 Raffle Ticket - $25.002 Raffle Tickets - $50.003 Raffle Tickets - $75.004 Raffle Tickets - $100.005 Raffle Tickets - $125.006 Raffle Tickets - $150.007 Raffle Tickets - $175.008 Raffle Tickets - $200.009 Raffle Tickets - $225.0010 Raffle Tickets - $250.00They are $25 each, with a maximum of 10 for this recipient.Gift Recipient #3: Name, Email & Phone Number *How many raffle tickets would you like for Gift Recipient #3? *1 Raffle Ticket - $25.002 Raffle Tickets - $50.003 Raffle Tickets - $75.004 Raffle Tickets - $100.005 Raffle Tickets - $125.006 Raffle Tickets - $150.007 Raffle Tickets - $175.008 Raffle Tickets - $200.009 Raffle Tickets - $225.0010 Raffle Tickets - $250.00They are $25 each, with a maximum of 10 for this recipient.Gift Recipient #4: Name, Email & Phone Number *How many raffle tickets would you like for Gift Recipient #4? *1 Raffle Ticket - $25.002 Raffle Tickets - $50.003 Raffle Tickets - $75.004 Raffle Tickets - $100.005 Raffle Tickets - $125.006 Raffle Tickets - $150.007 Raffle Tickets - $175.008 Raffle Tickets - $200.009 Raffle Tickets - $225.0010 Raffle Tickets - $250.00They are $25 each, with a maximum of 10 for this recipient.Gift Recipient #5: Name, Email & Phone Number *How many raffle tickets would you like for Gift Recipient #5? *1 Raffle Ticket - $25.002 Raffle Tickets - $50.003 Raffle Tickets - $75.004 Raffle Tickets - $100.005 Raffle Tickets - $125.006 Raffle Tickets - $150.007 Raffle Tickets - $175.008 Raffle Tickets - $200.009 Raffle Tickets - $225.0010 Raffle Tickets - $250.00They are $25 each, with a maximum of 10 for this recipient.Gift Recipient #6: Name, Email & Phone Number *How many raffle tickets would you like for Gift Recipient #6? *1 Raffle Ticket - $25.002 Raffle Tickets - $50.003 Raffle Tickets - $75.004 Raffle Tickets - $100.005 Raffle Tickets - $125.006 Raffle Tickets - $150.007 Raffle Tickets - $175.008 Raffle Tickets - $200.009 Raffle Tickets - $225.0010 Raffle Tickets - $250.00They are $25 each, with a maximum of 10 for this recipient.Gift Recipient #7: Name, Email & Phone Number *How many raffle tickets would you like for Gift Recipient #7? *1 Raffle Ticket - $25.002 Raffle Tickets - $50.003 Raffle Tickets - $75.004 Raffle Tickets - $100.005 Raffle Tickets - $125.006 Raffle Tickets - $150.007 Raffle Tickets - $175.008 Raffle Tickets - $200.009 Raffle Tickets - $225.0010 Raffle Tickets - $250.00They are $25 each, with a maximum of 10 for this recipient.Gift Recipient #8: Name, Email & Phone Number *How many raffle tickets would you like for Gift Recipient #8? *1 Raffle Ticket - $25.002 Raffle Tickets - $50.003 Raffle Tickets - $75.004 Raffle Tickets - $100.005 Raffle Tickets - $125.006 Raffle Tickets - $150.007 Raffle Tickets - $175.008 Raffle Tickets - $200.009 Raffle Tickets - $225.0010 Raffle Tickets - $250.00They are $25 each, with a maximum of 10 for this recipient.Gift Recipient #9: Name, Email & Phone Number *How many raffle tickets would you like for Gift Recipient #9? *1 Raffle Ticket - $25.002 Raffle Tickets - $50.003 Raffle Tickets - $75.004 Raffle Tickets - $100.005 Raffle Tickets - $125.006 Raffle Tickets - $150.007 Raffle Tickets - $175.008 Raffle Tickets - $200.009 Raffle Tickets - $225.0010 Raffle Tickets - $250.00They are $25 each, with a maximum of 10 for this recipient.Gift Recipient #10: Name, Email & Phone Number *How many raffle tickets would you like for Gift Recipient #10? *1 Raffle Ticket - $25.002 Raffle Tickets - $50.003 Raffle Tickets - $75.004 Raffle Tickets - $100.005 Raffle Tickets - $125.006 Raffle Tickets - $150.007 Raffle Tickets - $175.008 Raffle Tickets - $200.009 Raffle Tickets - $225.0010 Raffle Tickets - $250.00They are $25 each, with a maximum of 10 for this recipient.Please give us the best days and times to reach you and we will do our best to accommodate your schedule. Would you like us to send you a gift acknowledgment for your recipients?Yes, send a gift acknowledgementDonation Total (will be taken by phone)$0.00Upon receipt and verification of your form, payment for your raffle ticket(s) will be taken over the phone by one of our Executive Committee members. Please make sure your phone number at the top of the form is correct, as that is the number we will contact for processing and payment.Reserve Your Tickets