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Louis Vuitton Raffle

Fair Market Value = $1,260

Tax exemption # EXE0002121

Purchase Tickets

You may purchase tickets using the online order form below. Med Center Health employees who wish to purchase via payroll deduction may use the payroll deduction form.

Online order form

Med Center Health Employees Payroll Deduction Form

Payroll deduction form for employees to purchase raffle tickets to support Community Clinic via the Charity Ball.
  • Price: $25.00
  • $0.00
  • You may choose to pay in full or split your payment between two pay periods. The first deduction will occur on your next pay period.
  • I hereby authorize the Accounting/Payroll department to deduct the total amount indicated above through payroll deduction. I also understand and agree that in the event my employment with Med Center Health (and/or its affiliated corporations) is terminated before this obligation is satisfied, Med Center Health (and/or its affiliated corporations) may deduct any or all amounts in excess of Federal Hourly Minimum Wage from my final paycheck as consideration for payment on this account and that I will remain responsible for entire balance which will be immediately due and owing. Selecting "I Agree" below is your electronic signature to this agreement.
  • This field is for validation purposes and should be left unchanged.