TABLE FORM basket bingo by luckboy

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									Altoona Community Theatre Jingle Bell Basket Bingo!
6 P.M. Monday, deceMber 7, 2009 - Father Kelley hall
_____ General Admission Tickets at $20 _____ Ticket/Value Pack Combos at $55 $ _______ $ _______ MAKE CHECKS PAYABLE TO ACT and mail to: ACT, P.O. Box 908 Altoona, PA 16603-0908
or call the ACT office to charge to MasterCard or Visa 943-4357

TOTAL DUE $ _______

A hostess of 8 bingo players (including her) will be eligible for a special raffle drawing!

Hostess Name _________________________________________________
Ticket purchaser information must be complete. This is used for the grand prize drawing. No RefuNds -- No TickeT ReplAcemeNTs
NAME 1 _________________________________________ Address __________________________________________ __________________________________________ Phone # __________________________________________ E-Mail ___________________________________________
[ ] General Admission Only [ ] General Admission & Value Pack

NAME 5 _________________________________________ Address __________________________________________ __________________________________________ Phone # __________________________________________ E-Mail ___________________________________________
[ ] General Admission Only [ ] General Admission & Value Pack

NAME 2 _________________________________________ Address __________________________________________ __________________________________________ Phone # __________________________________________ E-Mail ___________________________________________
[ ] General Admission Only [ ] General Admission & Value Pack

NAME 6 _________________________________________ Address __________________________________________ __________________________________________ Phone # __________________________________________ E-Mail ___________________________________________
[ ] General Admission Only [ ] General Admission & Value Pack

NAME 3 _________________________________________ Address __________________________________________ __________________________________________ Phone # __________________________________________ E-Mail ___________________________________________
[ ] General Admission Only [ ] General Admission & Value Pack

NAME 7 _________________________________________ Address __________________________________________ __________________________________________ Phone # __________________________________________ E-Mail ___________________________________________
[ ] General Admission Only [ ] General Admission & Value Pack

NAME 4 _________________________________________ Address __________________________________________ __________________________________________ Phone # __________________________________________ E-Mail ___________________________________________
[ ] General Admission Only [ ] General Admission & Value Pack

NAME 8 _________________________________________ Address __________________________________________ __________________________________________ Phone # __________________________________________ E-Mail ___________________________________________
[ ] General Admission Only [ ] General Admission & Value Pack


								
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