Charity Entry Form :
Organization Name
*
Representative Full Name
*
First Name
Last Name
Organization Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization Phone Number
*
Representative Phone Number
*
Organization E-mail
example@example.com
Representative E-mail
example@example.com
Other (how did you hear about us?
*
Briefly describe the premise of your organization. Why should we choose to represent your charity? :
We require 5 minimum prizes from our chosen charity to be used at Bingo. What would you be willing to donate? Some previous examples were gift cards to local businesses, tshirts, or coozies. *NOTE: If you are hosting your charity event at both locations, you will be required to provide 10 total prizes (5 at Galloway and 5 at Fremont).
Would you be willing to briefly speak on behalf of your organization? What would you plan to say?
Is there a specific month that you would prefer to hold your charity event:
Submit
Should be Empty: