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Please complete the order form then submit order. This page contains a secure key to protect your financial information. If you have any questions contact our office at 225-356-7790.
 *Name  
 *Address  
 *City/State/Zip  
Phone  
E-Mail  
How many $10,000 Raffle Ticket(s) @ $100
Number  
How many Crawfish Dinners @ $15
Number  
Poker Run Entry @ $30 a Team
Number of Entries  
Pay Alumni Dues $20
 
  YES
Number of T-Shirts (Youth Sm- Adult XL) @$10
Total Number  
Number of T-Shirts (Adult XXL - Adult XXXL) @ $12
Total Number  
Shirt Sizes
Youth Small  
Youth Medium  
Youth Large  
Adult Small  
Adult Medium  
Adult Large  
X-Large  
XX-Large  
XXX-Large  
Payment Infomation (Accept Mastercard, Visa, and Discover)
 *Charge Amount  
 *Credit Card #  
 *Name on Credit Card  
 *Exp. Month  
 *Exp. Year  
 
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4000 St. Gerard AvenueBaton Rouge, LA 70805Tel: 225.357.0936Fax: 225.357.4555VM: 225.357.6680
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