Designer Bag Bingo Ticket Order

Anne Grady Foundation

Designer Bag Bingo Ticket Order
Thank you! Your support of Anne Grady Services will help us provide dignity, respect, and quality services to individuals with intellectual disabilities.

For more information or to ask questions, contact Stephanie Reighard at 419-866‑6500 ext. 274 or 419-410-5220.

* Indicates required fields
Are you 21 years old or older? *

Yes No

Number of Tickets: *

Individual Tickets = $40 Table of 4 = $150 Table of 8 = $300
Number of Individual Tickets *
Company Name / Individual *
Contact Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
E-mail *
Phone Number *
Amount Total
NOTE: Ticket price is nonrefundable.

Payment Information *

USD Dollar Amount

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

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We're sorry. You must be 21 years old or older to attend this event.
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