Win this Camper
Camper part
is new,
never used,
one of a
kind,
prototype!
Win this Unique Camper Van
Used Vehicle Information: 2003 Ford E350/143,000 miles
Raffle Tickets: $10 each
Drawing: August 13, 2016 3:00 pm (one winner)
at Coopersville Farm Museum
375 Main Street, Coopersville, MI 49404
Drawing will be done by an independent CPA - Winner has 14 days to claim prize.
Winner announced at Port City Racing
during Del Shannon Car Show Award Presentations no later than 4pm.
Need not be present to win - Winner is responsible for all taxes, licensing, and insurance.
Must be 18 years old or older at time of entry.
Camper/Van will be awarded “as is” with no refunds.
A minimum of 200 tickets will be sold at $10 each
If less than 200 tickets are sold by 8/13/16 at 3:00pm, the drawing will revert to a 50/50 drawing.
Raffle Rules are posted at www.coopersvillefarmmuseum.org and are available at
Coopersville Farm Museum.
This is a Fundraising Raffle with all proceeds benefiting Coopersville Farm Museum,
a 501(c)(3) non-profit organization.
Michigan Raffle License #R37871
Tickets may be purchased in person, by mail, by email, or by phone. Please complete the order form below or stop by the Coopersville Farm Museum, 375 Main
Street, Coopersville, Michigan during regular business hours. Emails should be
sent to: [email protected]. You will receive a confirmation
email. If you do not receive confirmation, please contact the museum by phone
at 616-997-8555.
ORDER FORM
Number of Tickets _______ @ $10 each
Total Amount $______________
□ Check made payable to Coopersville Farm Museum □ Money Order
□ Cash □ MC □ VISA CC # _____________________________________
Expiration Date ________ Verification Code ______ Billing Zip Code ________
Mail payment: Coopersville Farm Museum, PO Box 64, Coopersville, MI 49404
Name__________________________________________________________
Address ________________________________________________________
City _______________________________State______ Zip _______________
Phone _________________________________________________________
email__________________________________________________________
Signature _______________________________________________________
Ticket(s) will be mailed within five days of receipt of payment
Do not mail cash!
Winner will be notified in person, by phone, or email provided above.
Winner must claim prize within 14 days of notification.
License #R37871