CTK Champion Challenge Prize Form

All forms must be submitted no later than Thursday, October 1st.

Questions about this form or general questions related to Champion Challenge prizes, please contact Whitney Scotto at whits502@yahoo.com.

Please complete one form per student.
Email address *
Student First Name *
Student Last Name *
Student Grade *
Total Amount Collected - include all online, cash, check and company match pledges *
Please select from the below list of prize categories:
**Prizes subject to change at the discretion of the committee**
**Prizes may not be the same as pictured**

ONLY (1) FREE DRESS ZOOM PASS WILL BE GIVEN TO EACH STUDENT.

Prizes are not cumulative. For example, if you collect $150 you get ONE Free Dress Zoom pass with a Boho Bandeau or Rock Painting Kit or Tech Deck.

Prizes can be combined to total the amount you collected. For example, if you collect $150 you can choose a Tie Dye Kit OR a Football OR a $10 In-N-Out Gift Card with a Free Dress Zoom pass (from the $100 prize category) & a Flashlight Keychain OR a $5 In-N-Out Gift Card (from the $50 prize category).
$25 Category - please select one option from below
$35 Category - please select one option from below
$50 Category - please select one option from below
$75 Category (includes Free Dress Zoom Pass) - please select one option from below
$100 Category (includes Free Dress Zoom Pass) - please select one option from below
$150 Category (includes Free Dress Zoom Pass) - please select one option from below
$200 Category (includes Free Dress Zoom Pass) - please select one option from below
$300 Category (includes Free Dress Zoom Pass) - please select one option from below
$400 Category (includes Free Dress Zoom Pass) - please select one option from below
$500 Category (includes Free Dress Zoom Pass) - please select one option from below
$1,000 Category (includes Free Dress Zoom Pass) - please select one option from below
$2,000 Category (includes Free Dress Zoom Pass) - please select one option from below
Grand Prize - Student who collects the most money will win Bose Headphones.
Click below if you’d like to contribute the value of your prize back to CTK. Students who raise $75 or more and select this option will receive a Free Dress Zoom Pass.
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