TICKET PURCHASE | CLC VIRTUAL GAMESHOW FUNDRAISER

General Information
First Name *
Last Name *
Address *
City *
State *
Zip Code *
Phone *
E-mail *
Attendee Information
Number of Participants *
Number of Adults *
Number of Children *
Contestant Details
Our Virtual Gameshow will have randomly selected participants. Please indicate below if you are interested in being a contestant. ALL potential contestants that have indicated YES need to attend the sound check session on Thursday evening, December 3 at 6:15 p.m. The Gameshow will be streamed on ZOOM; however, selected candidates will need to connect via SKYPE for their game session.
Are you interested in being a contestant on the game show? *
Do you have a SKYPE account?

Yes No
What is your SKYPE Name?
Please watch your e-mail for directions on obtaining a SKYPE account. This type of account will be required to connect and appear as a contestant on the show.
PURCHASE TICKETS

ALL PAYMENTS PROCESSED SECURELY THROUGH PAYPAL

OPTIONS

VIP ZOOM ADMISSION $ 150.00

VIP ZOOM Admission includes your ZOOM session ID and delivery of your special event kit on Thursday, December 3.

GENERAL ZOOM ADMISSION $ 100.00

General admission includes your ZOOM session ID and a special event kit that will be available for pickup at 5825 Chantry Drive, Columbus, 43232 11 a.m. - 7 p.m. on Thursday, December 3. Directions for safe pickup will be e-mailed to individuals that select this option.

DONATION

Area of Need	Quantity	Price
Celebrating FIFTY		$ 50.00
Chromebook Purchase		$ 200.00
Certificate Program for 1 Youth		$ 500.00
GED Prep and Test Fees for 1 Adult Student		$ 1,000.00
ESOL Classes for 4 months		$ 1,500.00
Work-Experience for a Young Adult		$ 2,500.00

Total $ 0.00

Pay with Credit Card

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Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

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General Information

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Contestant Details

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