Sign up to be a Sponsor!


Please fill out and submit the form below. A registration
representative will contact you to obtain payment information.










  Bronze($750.00)(includes 2 tickets)   Silver ($1,500.00)(includes 4 tickets)   Gold ($2,500.00)(includes 6 tickets)  Platinum ($5,000.00)(includes 8 tickets)  Other Amount, please specify below





Would you prefer to mail in your registration?
Click here to print a copy of this form.


"Pursuant to IRS Publication 526, amounts paid to play a 'game of chance' cannot be deducted
as a charitable contribution; therefore, ticket purchases for the 2013 Casino Night Scholarship
Fundraiser are not tax-deductible."


For more information, call Michelle Girage at 770-499-3340.