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Merchandise
Price
Quantity
Amount
Live Auction Ticket *Pint Glass & 2 Drink Tix
$25.00
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
$
Raise the Paddle - $5000
$5,000.00
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
$
Raise the Paddle - $2500
$2,500.00
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
$
Raise the Paddle - $1000
$1,000.00
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
$
Raise the Paddle - $500
$500.00
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
$
Raise the Paddle - $250
$250.00
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
$
Raise the Paddle - $100
$100.00
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2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
$
Raise the Paddle - $50
$50.00
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
$
Reserved Table for 8 (includes 8 auction tickets)
$500.00
1
2
3
4
$
$
Contact Information
Person 1 First Name:
Person 1 Last Name:
Person 1 Mobile:
Person 1 Email:
Person 2 First Name:
Person 2 Last Name:
Person 2 Mobile:
Person 2 Email:
Street:
City:
State, Zip:
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AB
AE
AK
AL
AP
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AZ
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CT
DC
DE
FL
GA
GCM
HI
IA
ID
IL
IN
JM
KS
KY
LA
MA
MB
MD
ME
MI
MN
MO
MS
MT
NA
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VA
VT
WA
WI
WV
WY
YT
Home Phone:
Password:
Payment Information
Payment Method:
American Express
Discover
MasterCard
VISA
Card Number:
Exp. Month:
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Exp. Year:
2023
2024
2025
2026
2027
2028
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2030
2031
Security Code:
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