Priory Free Winter Lights Wedding Application - Pittsburgh First Responder
RequiredRequired Question(s)
Winter Lights Wedding™ Reception First Responder Drawing Application and Verification of Eligibility
In the event that you are the lucky winner, you must provide proof of employment by the City of Pittsburgh as a uniformed member of the Emergency Medical Services, Pittsburgh Bureau of Police or Pittsburgh Bureau of Fire
Winner will be chosen by random drawing on September 25, 2018 - First Responders Day - on KDKA-TV's Pittsburgh Today LIVE morning show. 
The following is a summary of the rules of the drawing for a complimentary Winter Lights Wedding™ reception imposed by the contest sponsors the Graf family and Priory Hospitality, Inc. and their service provider partners (see the Winter Lights Wedding™ Drawing Rules and Regulations, which may be found at or at for a comprehensive set of requirements for eligibility): No purchase or fee is required, but the drawing is only open to a member (and "spouse to be") of a current uniformed employee in good standing of the City of Pittsburgh Emergency Medical Services, Bureau of Police, or Bureau of Fire. The wedding reception must take place at The Grand Hall at The Priory on a Friday or Sunday between January and March 2019 (subject to date avai
To enter the contest, please enter the information indicated below.

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Job Title:
Company Name:
Work Phone:
Email Address:
Business Address1:
Business City:
Business State:
Business Zip Code:

Required 2.

Current job title and rank (if applicable), department, location of First Responder. 


350 characters left.
Required 3.

Date First Responder's service started.


50 characters left.
Required 4.
Name of fiancée (fiancé):

50 characters left.
Required 5.
Phone number of fiancée (fiancé):

50 characters left.
Required 6.

E-mail of fiancée (fiancé):


50 characters left.
Required 7.
Your Service As a First Responder
So we can get to know a little more about you, please, in narrative form, tell us a little about your experience as a First Responder in the City of Pittsburgh. Winners are chosen by random drawing, so the essay does not play a part in the evaluation of your application. A paragraph will do:


350 characters left.
Required 8.
Attestation - First Responder
I certify that I am, at the time of the submission of this application, a uniformed employee in good standing of the City of Pittsburgh Bureau of Police, City of Pittsburgh Bureau of Fire, or City of Pittsburgh Emergency Medical Services, and that all of the information provided herein is, to the best of my knowledge, is true and correct, and I will indemnify and hold harmless Priory Hospitality, Inc., the Graf family, and their officers and employees, and their service provider partners, from any loss or damage that arises from any misrepresentation. I have read and agree to abide the Winter Lights Wedding ™ Reception Drawing Rules and Regulations, and will abide by the same. I do hereby allow a representative of Priory Hospitality, Inc. to contact anyone or organization to verify the statements made on this Application.
            The following Attestation is made subject to penalties for perjury authorized by Pennsylvania law for unsworn oaths.
_____________________________                             (Signature of First Responder)
                                                            [Or - type name for electronic submission]


50 characters left.