Attend both of these events for $18, and proceeds will go towards the COVID Relief Fund.

* Couvert$ 18.00
* Event Date
 
Personal Information
* Title
* First Name
* Last Name
Maiden Name
* Date of birth
/ /
CJA account
Home Address
* Address
Apt.
* City
* Province
* Postal Code
Home Phone
* Phone
Primary Email
* E-mail
* Do you want to make a gift to the COVID Relief Fund?
This portion is tax deductible.
Yes 
No 
Credit Card Information
* Credit Card Number
Please do not enter spaces
* Cardholder's Name
(As it appears on your Credit Card)
* Card Type
* Expiry Date
/
* Verification Number
The Verification Code is a three-digit number on the back of your Visa or Mastercard credit card
Total $ 18.00
SMTWTFS
     
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