Illinois Hands & Voices Bingo Night Fundraiser Ticket Purchase Form

Illinois Hands & Voices Bingo Night Fundraiser Ticket Purchase Form

Must be 18 years or older to attend the event or purchase 50/50 raffle tickets. Please fill out your details and select your ticket options.
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
If you are attend the event on October 17th, do you have any accessibility Needs (select all that apply)

ADA - Other (please specify)
Ticket Purchase (please select all that apply and choose quantity for each ticket type)
prevnext( X )
Event Ticket
Admission to Bingo Night Fundraiser includes admission, dinner and bingo.

$45.00 Quantity



50/50 Raffle Ticket (1 Ticket)
DO NOT NEED TO BE PRESENT TO WIN, winning ticket pulled on October 17.

$5.00 Quantity



50/50 Raffle Ticket (5 Tickets)
DO NOT NEED TO BE PRESENT TO WIN, winning ticket pulled on October 17.

$20.00 Quantity



Total

$0.00
Are you purchasing more than one event ticket today? If you are attending and purchasing tickets for others, select yes. Reminder: attendees at the event on October 17th must be 18 years or older.
If you are purchasing more than one event ticket. Please list all additional names that will attend with you. NOTE: all attendees must be 18 years or older.
Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
Should be Empty:

Illinois Hands & Voices Bingo Night Fundraiser Ticket Purchase Form

Ticket Purchase (please select all that apply and choose quantity for each ticket type)*

Payment Methods

Ticket Purchase (please select all that apply and choose quantity for each ticket type)