St. Stephen Martyr Reverse Raffle Wheel of Chance Order Form
Drawings to be held January 30, 2016
License # 0192
2931 Pindell Avenue, Louisville, KY 40217
Be a part of the 2016 SSM Reverse Raffle with our Wheel of Chance and help SSM raise money for projects to further improve our school.
You need not be present to win. Only 100 tickets will be sold for each of the fabulous prizes. Prices for each item are listed alongside the item
description. The postmark date will determine the first 100 replies for each item. In the event that more than 100 replies are received for a
package we will call you to offer another selection. We will assign your number when we receive your request and your ticket numbers will be
sent to you.
To purchase your Wheel of Chance ticket(s), please complete and return this entire form with a check made payable to St. Stephen Martyr.
Item
#
Item Description
1 Jukebox
Cost
Total Chances to
Purchase
$20 _____x $20 =____
Olfashioned style that will play iPod, CDs,
or radio
2 Vizio Sound Bar
3
4
Golfer’s Delight
Foursomes at area courses
$5
____ x $5 = ____
17
____ x $7 = ___
Beats Wireless Pillbox
5 Speaker
$7
____ x $7 = ____
6 $200 Gas Card
$6
____x $6 = ____
$5
___ x $5 = ____
8 $200 Frank’s Meat Package
$6
____6 x $ = ____
9 $200 Franks Meat Package
$6
___ x $6 = ____
$200 Frank’s Meat Package
10
11 Dinner for a Year
$5
____ x $5 = ____
$5
$6
____ x $6 = ____
$5
____ x $5=_____
$6
____ x $6 = ____
$6
____ x $6 = ____
Freezer with Kroger Gift
20 $200 Gas Card
21 Apple iWatch
$10 ___ x $10 = ____
Disney Get-Away
____ x $5 = ____
____ x $3 = ____
23
13 Apple iPad Mini 16GB
$10 ____ x $10= _____
24
14 Samsung 48 inch Smart
TV 1080p
$12 ____ x $12= _____
12 gift certificates valued at $20 or more to
area restaurants
Four 1-day park hoppers, a 3 night stay at
Red Roof Inn & $50 in Disney Bucks
$10 ____ x $10 = ____
Fit Bit Charge HR
$3
____ x $5= ____
$200 Value
12 Fast Food Gift Certificates!
$6 ____ x $6 = ____
$5
Total Chances to
Purchase
$200 Gas Card
18 Fast Food for a Year
22
12 Fire Pit
Four Admission Tickets
19 Card!
Backyard Smoker
Pro Series Hallow Gas Smoker with
accessories and wood chips!
Holiday World Tickets
Cost
16 Samsung Smart Blu-ray
$10 ____ x $10p = ____
$7
7
15
Item Description
Wireless with 250+ apps includes
Beats Solo 2 Headphones
Sharp grey color
Item
#
Beautiful Plum Color
$5
___ x $5 = ____
$10
____x $10 = ___
$5
____ x $5 = ____
Hampton Bay outdoor Fire Pit
$500 SSM Tuition Voucher
A minimum of 50 chances must be sold.
$150 SSM Lunch Voucher
25
Can be split between siblings.
Faculty & staff are eligible.
A minimum of 50 chances must be sold.
Total # of Tickets Purchased ______TOTAL: $______
Name(s) on tickets: ______________________________________________________________ Phone #:__________________Cell __________________
Address: ___________________________________________________________ City: _____________________ State: ______ Zip Code: ___________
Please mail this form along with check to: St. Stephen Martyr Reverse Raffle, 2931 Pindell Ave., Louisville, KY 40217.
If you have any questions, please contact
PLEASE RETURN MY CHANCES TO ME BY:
Mail
Pick up Church Office
Send home with student: ________________________________________ Homeroom _________