First Kiss and/or First Hug Ticket

Order Form
Tickets are 3 for a $1.00 donation; please fill out the order form below. There is a
$50.00 donation limit per first kiss/hug. That’s a total of 150 chances to win per
first kiss/ hug! Please write legibility so we can contact the winner immediately.

Sailor’s Name:
_________________________________________________________________________

Department/Division:
___________________________________________________________________

Spouse’s/Finance’s (YOUR) Name:

_________________________________________________________

Phone Number:
________________________________________________________________________

** FIRST KISS** First Kiss receipt:

$ ______________ x 3 = _____________ $ ______________ x 3 = _____________

Tickets Tickets

Example: $_10_ x 3 = _30_ Tickets GRAND TOTAL:

$_____________________ x 3 =

Circle One: Cash Check

Number________ J FIRST HUG J

$ ______________ x 3 = _____________
Tickets

Example: $_10_ x 3 = _30_ Tickets

Circle One: Cash Check

Number________

Children’s name and age

1. -
_____________________________________

**Please do not write below this 2.

line** _____________________________________
3.
_____________________________________

4.
_____________________________________

5.
_____________________________________

6.
_____________________________________

**Please do not write below this

line**

First Kiss receipt:

$ ______________ x 3 = _____________
Tickets

___________ Tickets __________FRG

INITIALS