Stevens Center Prime Rib Dinner Plate Sale Reservation Form
Fill out this form to reserve your plates to pick up at the Stevens Center, 1576 Kelly Dr. on Saturday, February 13th, 2021.

To pay with a credit card or paypal visit this link: https://www.paypal.com/donate?hosted_button_id=TGX7SYT74FQUL/
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Email *
Name Meals Reserved Under: *
Dinner Options
Prime Rib Dinner:

Chicken Breast Dinner: $35
Includes: Chicken Breast, Baked Potato, Green Beans, Garden Salad, Roll and Home-baked Dessert

Option: Dinner Delivery
(within 5 mile radius): $10 per address

Raffle Ticket: $20
Chicken Breast Dinner Quantity ($35 each):
Dinner Delivery (within 5 mile radius of the Stevens Center, $10 per address) quantity:
Dinner Delivery Address (if applicable):
Name and Phone Number at delivery site:
Preferred delivery time (if applicable, not guaranteed):
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Raffle Ticket Quantity ($20 each):
A chance to win a $600 Raffle package including a 2-night stay at the beautiful Traders Gap Mountain Cabin. Visit www.kingvacationrentals.com for more details.
Payment Method *
To pay with a credit card or paypal visit this link: https://www.paypal.com/donate?hosted_button_id=TGX7SYT74FQUL/ 
Total Payment Amount: *
NOTE: If you pay through Paypal, bring your donation receipt email when you pick up your dinners.
A copy of your responses will be emailed to the address you provided.
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