Glowmania – Saint Andrew Parish

Get Ready to glow the night away dancing!

Wear white and neon….

Friday, August 1st at 7:00PM
Saint Andrew Social Hall

Serving Appetizers, Beer, Wine, Sodas
*Must be 21+ years to attend. Any questions regarding this form, please e-mail websiteadmin@sacccs.org

Glow Dance Party Ticket Purchase Form

Single Tickets

240 tickets remaining.

Price includes a beverage, glow wand, appetizer and open seating at non-reserved tables.

Price:

How many single tickets do you want to purchase?(Required)

*A maximum of 7 single tickets may be purchased in one transaction.

Guest Name: Single Ticket 1(Required)

First Name Last Name

Guest Name: Single Ticket 2(Required)

First Name Last Name

Guest Name: Single Ticket 3(Required)

First Name Last Name

Guest Name: Single Ticket 4(Required)

First Name Last Name

Guest Name: Single Ticket 5(Required)

First Name Last Name

Guest Name: Single Ticket 6(Required)

First Name Last Name

Guest Name: Single Ticket 7(Required)

First Name Last Name

Seat Ticket Sub-Total

Table of Eight

20 tables remaining.

Price:

How many tables of eight would you like to reserve?(Required)

*A maximum of two tables of eight may be purchased in one transaction. Guest names are required. Any name changes after submission must be sent to websiteadmin@sacccs.org

Table of Eight: Guest 1(Required)

First Name Last Name

Table of Eight: Guest 2(Required)

First Name Last Name

Table of Eight: Guest 3(Required)

First Name Last Name

Table of Eight: Guest 4(Required)

First Name Last Name

Table of Eight: Guest 5(Required)

First Name Last Name

Table of Eight: Guest 6(Required)

First Name Last Name

Table of Eight: Guest 7(Required)

First Name Last Name

Table of Eight: Guest 8(Required)

First Name Last Name

Table of Eight: Guest 9(Required)

First Name Last Name

Table of Eight: Guest 10(Required)

First Name Last Name

Table of Eight: Guest 11(Required)

First Name Last Name

Table of Eight: Guest 12(Required)

First Name Last Name

Table of Eight: Guest 13(Required)

First Name Last Name

Table of Eight: Guest 14(Required)

First Name Last Name

Table of Eight: Guest 15(Required)

First Name Last Name

Table of Eight: Guest 16(Required)

First Name Last Name

Table Ticket Sub-Total

50-50 Raffle Tickets - $5 Each

Please select how many tickets you want to purchase,

Additional Food Tickets - $5 Each

Please select how many tickets you want to purchase,

Drink Tickets - $5 Each

Please select how many tickets you want to purchase,

50-50 Raffle Ticket Sub-Total

Additional Food Ticket Sub-Total

Drink Ticket Sub-Total

Contact and Billing Information

What is your name?(Required)

First Name Last Name

Primary Telephone Number:(Required)

Secondary Telephone Number:

Email Address (for Billing and Receipt)(Required)

Enter Email Confirm Email

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code

Amount Due:

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name