One Community Gala 2020 Form -

YOUR INFORMATION
Name*
First Last
Address*
City*
State*
Zip*
Telephone*
Email*
INDIVIDUAL TICKET PURCHASE

TICKET INFORMATION
Individual Quantity
Price: $180.00
Guest Names
RAFFLE
I want to purchase additional Basket Raffle Tickets (each sheet has 21 tickets)
Raffle Tickets $20 per sheet Quantity
Price: $20.00
CRUISE RAFFLE

Win a 7 day $2,500 value CelebrityXCruise for 2 to a destination of your choice (some restrictions apply)

Drawing takes place at GALA. Winner need not be present. Winner responsible for all taxes and fees.

Tickets $36 each or 3 for $100.
Cruise Raffle Individual Tickets @ $36 each Quantity
Price: $36.00
Cruise Raffle Group of 3 tickets Tickets @ $100 Quantity
Price: $100.00
HOLOCAUST SURVIVOR ADMISSION SPONSOR
Purchase an admission ticket for one or more survivors - or Call for information Quantity
Price: $180.00
CONTRIBUTION ONLY
New donations or to pay your pledge.
Amount of Contribution
PAYMENT INFORMATION
Credit Card*

American Express
MasterCard
Visa
Supported Credit Cards: American Express, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Total
$0.00

One Community Gala 2020 Form