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Event Registration

Event Name	Event Price	Qty
2nd Annual Chips for Charity casino night on March 3, 2012; Blue Ball Barn, Wilmington, DE, INDIVIDUAL TICKET	$100.00
2nd Annual Chips for Charity casino night on March 3, 2012; Blue Ball Barn, Wilmington, DE., COUPLE	$175.00
Fund For Women 100th Anniversary of the Delaware Art Museum, March 1, 5:30 p.m.	$20.00
Fund for Women, Fashion, Fun and Philanthropy Show, April 22, 2012 from 1 to 4 p.m, Cordrey Center, East Coast Garden Center, 30366 Cordrey Road, Millsboro, DE	$20.00

Registration and Billing Information
For registrations, please complete the following information for our records. For registrations that include a fee, please note the address entered below must match the billing address of your credit card.
* indicates a required field.

First Name *
Last Name *
Address 1 *
Address 2
City *
State *
Zip *
Phone *
Email *
Fax

I wish to pay by Credit Card.

Credit Card
Name on Credit Card
Credit Card Number
Credit Card Exp. Date
CCV Code

I will send a check, payable to Delaware Community Foundation, to 100 W. 10th Street, Suite 115, Wilmington, DE 19899.

Please list attendee names, one per line. *