Print & Mail .................................................................................... Name: _______________________________________________________ Address: _____________________________________________________ City: ________________________________________________________ State: _______________________________________________________ Phone: ______________________________________________________

Banquet Package Membership & Dinner --> $55.00....................... Sponsor Membership --> $250.00...................................... ***************************************************************************
Additional Dinners only $20.
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Number of Memberships: _________________________________ *************************************************************************** Number of Dinners: _____________________________________ *************************************************************************** Tickets on featured gun:_____________________________ 
Featured  Shotgun - $10.00 ticket ........................ *************************************************************************** Tickets on our featured print: _______________________________ Redlin Print - $5.00 for 1 & 3 for $10 *************************************************************************** Tickets on our tier raffle: ___________________________________ $40 per book................................................................................ *
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We will have 15 guns on our program and several packages of ammunition.  Your tickets will be held at the door for you to pick up the night of the banquet.
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Make checks payable to Livingston County Pheasants Forever, PO Box 304, Forest, Illinois, 61741..........................


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