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Hilltop High School
DOLLARS for SCHOLARS (TM)(R)

FUNDRAISING RAFFLE
ENTRY Form

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Name:

email address:

Street Address:

City, State, Country, ZIP:

Phone Number: (W)

Phone Number: (H):

Check all that apply:

Notify me if I am a winner.

Notify me of winners by e-mail even if I am not a winner.

Give me an even chance of winning each prize (default).

Example
($15)

I prefer to allocate my raffle chances as follows (max 1:$1, or 6:$5)

   Bob's On The Bay                                      (Chula Vista) Value: $40 D

   Outback Steakhouse                                  (nationwide)            $40 D

   Red Lobster                                                (Chula Vista)           $40 D

   Chili's                                                      (S.D. County)           $25 D

   Subway's (5)                           (Chula Vista - Terra Nova)         ~ $ 5 D

   San Diego Padres (2 Field level tickets, July 5: 7:05pm, Giants)      $54 A

   Complimentary facial and color makeover, plus
      complimentary Mary Kay products (3)        (UTC area)     $20 / $10 O

   Complimentary haircut (man or woman)        (Chula Vista)            $14 O

   Firestone - free oil change and tire rotation   (Chula Vista)            $22 O

      D - Dining / Food     A - Activities     O - Other

2

2

2

2

1

3

1

1

1

Instructions:

Fill out this form, click Submit button below ASAP/not later than 5pm June 6.
Mail check as soon as possible (must be received by June 9 for raffle) to: *
   Hilltop High School Dollars for Scholars
     c/o Hilltop High School
     Attn: Scholarship Counselor, Kathy Rahilly
     555 Claire Avenue
     Chula Vista, CA 91910
OR deliver check to your local raffle coordinator by June 6.
(Use Comments field below to request name/location of nearest coordinator).

OPTIONAL:

Comments:

How to reflect my donation:
(examples: John Jones, John and Jane Jones, Mr. & Mrs. John Jones, etc

Anonymous

In Memory of / In Honor of:

My Graduating Class Year:

Affiliation, if any (Parent, Student, Staff):

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