Professionals Affinity Group Breakfast and Study

Breakfast is $5 per person.

When registering, please use the email address that Beth El has on file, if applicable.

Registration Information

First Name

Last Name

Email:

Address

City

State

Zip Code

Ticket Information

Number of Attendees

at $5 each

Total Amount:

Please list the names of all attendees.

Please let us know if you have any allergies, dietary concerns, or special instructions.

Please select a payment method:

Credit CardACH/eCheck

Electronic Check (ACH) Payment

Bank Routing Number

Bank Account Number

Confirm Bank Account Number

Bank Account Type

Bank Name

Account Holder Name

There is a 3% transaction fee for paying by credit card. There is no fee for paying by eCheck.

I understand and agree to the 3% transaction fee.

3% Fee Information

Fee

New Total

Credit Card Payment

Credit Card Number

Verification Code

Card Expiration (Month)

Card Expiration (Year)

Use a different billing address?

YesNo

Billing Street

Billing City

Billing State

Billing Zip Code

Please click the Submit button only once to avoid being charged multiple times. No refunds.

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