Order Now Fill out the fields and submit your information Raffle Ticket* Quotation request only Order Form Dealer Contact InformationCompany Name Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone*Fax Contact Person E-Mail* Ship to Dealer or Drop Ship? DEALER DROP SHIP Shipping InformationName Address Street Address City State / Province / Region ZIP / Postal Code SizeSize* Standard 2-3/4” x 6-3/8” Jumbo 3-1/2” x 6-3/8” Super 3-1/2” x 8-1/2” QuantitiesQuantities* Loose Tickets Books Total Number of Tickets Number of booksHiddenNumber of booksNumber Of Tickets Per Book Stock Selection*20# Bond67# Vellum BristolChoose Your Color White Canary Ivory Green Blue Pink Gray Goldenrod Other Covers: Are no longer standard and are available at an additional cost. Will Use Credit Card On FIle Special instructions : Standard orders are shipped within 7 business days from proof approval via UPS ground. For residential orders, additional shipping costs may apply. Black Ink with Red #’s & Blind Perfs Blue Ink with Red #’s & Blind Perfs Other Ink with special instructions) Start number (0001 is standard) Stub copy Name, Address, City/St/Zip, Phone Other (Use Special Instructions) Special instructions Orders will not be produced without a signed proof. See Attached E-Mail Proof PDF only Upload Template Files Drop files here or Select files Accepted file types: psd, eps, indd, pdf, jpg, gif, png, Max. file size: 512 MB. A. DEMAREST LLC 74 Main St. Sidney, NY 13838 Phone: (888) 708-2920 • FAX: (888) 708-8188 • E-Mail: tickets@ademarest.com Δ
