Hockey Regina Inc

Hockey Regina BINGO Credit Form – In Season

2015 – 2016 Season **EXAMPLE**

Team Name: PW AA Blues____Submitted by: J.Smith_ Date: Jan 7/16____

(eg. PW AA Blues)

Registration Fees: FEMALE CO-ED AA A B C

Initiation ______$ 360.00 $ 360.00

Novice ______$ 710.00 $ 710.00

Atom ______$ 1060.00 ------$ 1060.00 $ 1060.00 $ 825.00

PeeWee ______$ 1100.00 A ------$ 1625.00 $ 1450.00 $ 1450.00 $ 1000.00

PeeWee ______$ 1450.00 AA

Bantam ______$ 1100.00 A ------$ 1675.00 $ 1450.00 $ 1125.00

Bantam ______$ 1450.00 AA

Bantam/Midget Rec ____ $ 625.00

Midget ______$ 1080.00 A ------$ 1800.00 $ 1375.00 $ 1050.00

Midget 15 $ 1375.00

Midget ______$ 1450.00 AA

Mailing information: Phone # _306-123-4567______

__123 ABC Avenue______

__S4Y A6B______

Voucher Amount / Voucher Numbers / Total # Vouchers / Total $$ Amount
$45 / 1587,1588,1599,1320 / 4 / 180
$60 / 0201 / 1 / 60
$80 / 1122,2233,5566 / 3 / 240
Total Bingo Credits / $ 480
PLAYER’S
FIRST NAME / PLAYER’S
LAST NAME / (A)
CURRENT SUBMISSION / (B)
SUBMITTED PREVIOUSLY / (A+B) TOTAL
(see above for Max $$)
1. / Wayne / Gretzky / 180 / 325 / 505
2. / Tommy / Jones / 300 / 0 / 300
3.
4.
5.
6.
7.
8.
HRI Cheque # ______TOTAL / $ 480