Childress for Judge Music Bingo Sign Up Form

Full Name*

First NameLast Name

Email Address*

example@example.com

Phone Number*

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Select Your Ticket Option

Individual Bingo TicketSingle Bingo ticket for $50.00

$50.00 Quantity

Table of 8Full table of eight for $400.00

$400.00 Quantity

Round Sponsor Logo displayed during round

$150.00 Quantity

Silver SponsorLogo displayed during round & on tables

$300.00 Quantity

Gold SponsorLogo displayed during round, on tables, & on campaign website.

$500.00 Quantity

Platinum SponsorLogo displayed during round, on tables, on campaign website, & 100 word message read by emcee during event (Childress for Judge reserves the right to deny or edit message content that would violate campaign and/or judicial ethics.)

$750.00 Quantity

Drink SponsorLogo displayed at bar. (only 4 available)

$500.00 Quantity

Total

$0.00

Overall Campaign Volunteer Sign-Up Options - I am interested in:

Putting a sign in my yardWorking a political pollKnocking on doorsOther

Additional Comments or Special Instructions

Join Us for a Music Bingo Fundraiser!