BBQ Ticket Order 2017

 

Name:*
Address:*
Residential Phone:*
-
E-mail:*
Employer:*
Occupation:*
Are you a lobbyist OR the spouse or dependent child of a lobbyist? (please check one)*
I further certify that I am not a principal of a state contractor or a potential state contractor. I am a United States citizen or a foreign national with permanent resident status. I am 18 yrs of age or older and have provided my residential address. I also certify that this donation is made from my personal funds. Please check.*
I certify that all of the information disclosed and set forth above is true to the best of my knowledge. Please check.*
BBQ Tickets @ $40.00 each - Leadership Circle @ $80.00 each

(may use combination)

Number of BBQ Tickets*
Total:
Payment is made securely using PayPal.

If you don't have a PayPal account you may use your debit or credit card. Click "Pay Now" then click "Pay with Debit or Credit Card" on the next page.

You will get a receipt when your transaction is completed, which will serve as your ticket(s).