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ABCCONN

Celebrate Faithfulness Gala

    
First Name
Last Name
Phone Number
Email Addresss
Church
Date
Amount

$75.00 each ticket or $700 for 10 person table

Description

Please list all names of people attending for name tags.

Name as on Card
Card Billing Address
Card Billing Zip
Card Number
Card Expiration Date
CVV2/CID