TWU's SECC BINGO Pledge Form
We appreciate your donation to this event!  Please complete this form to indicate your participation and how many BINGO cards you would like.  Each card costs $1 and may only be used once for all the games.  If you are donating for multiple individuals, please indicate so in the comments area including name, email, # of cards, and if they are attending in-person (or via zoom) for each individual.  We will email a link to those that are registered for the Zoom meeting and have cards printed for those that are attending in person.

If you wish to participate at both BINGO Sessions, please complete this form two times - once for each session.

All donations made by cash or check (made out to SECC) can be mailed by inter-campus or snail-mail to:

TWU SECC
c/o Nora Sierra
Institutional Research and Improvement
ACT 10th floor
304 Administration Dr.
Denton, TX 76204

For credit card payments, please contact Nora directly at 940-898-3352.
Email *
I am registering for the BINGO session on
 *
I will be attending: *
First Name *
Last Name *
Department/Component *
Work Phone *
Please use full 10 digits  - i.e.  XXX-XXX-XXXX
The number of BINGO cards I would like to receive *
You will receive 1 card for each $1 donated.
Comments
Please indicate if you are donating for multiple individuals here by providing their name, email, and # of cards for each individual so we can send them their cards.
Terms & Conditions
By registering and participating in this event, I hereby acknowledge and agree to the Terms & Conditions (Liability Waiver and Photographic Consent & Release) at https://twu.edu/secc/terms-conditions/
A copy of your responses will be emailed to .
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