Black & Gold Raffle Interest Form

If you are interested in purchasing tickets for the Black & Gold Raffle, please complete the form below. A member of our staff will contact you to handle payment and mailing of your raffle tickets. Should you need additional assistance, please contact Fleetwood Flemming at (248-370-4034,

First Name

Last Name




Zip Code

Phone Number

Email Address

Number of Tickets Requested:

Tickets x $5 each

Books (5 tickets each) x $20 each


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