2020 CASAblanca Registration Form
Select one ticket option
*
Individual Virtual Tickets - $150.00 per ticket
Virtual Viewing Party Table (10 Tickets) - $1,500.00 for tickets
Number of Tickets
1
2
3
4
5
6
7
8
9
Viewing Party Name
ex. Cindy Smith Crusaders or Jones Hardware Supporters (Max 50 characters)
Have you attended CASAblanca in the past?
*
Yes
No
Are you a past CASA supporter?
*
Yes
No
If yes, indicate your connection to organization
*
Select One
Board Member
CASA Volunteer
Donor
Event Participant
Event Volunteer
Former Board Member
Media
Partner
Potential Event Participant
Potential Volunteer
Staff
Title
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Mr
Mrs
Miss
Ms
First Name
*
Last Name
*
Suffix
Type of Address
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Home
Work
Address
*
City
*
State
*
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
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MS
MO
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NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
*
Primary Phone Number
*
Phone Type
*
Select One
Cell Phone
Home Phone
Work Phone
Secondary Phone Number
Phone Type
Select One
Cell Phone
Home Phone
Work Phone
Email Address
*
Contact Preference
*
All
Phone
Email
Text
Mail
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Submit Registration Form