Gala Registration - Indian American Cancer Network (IACAN)

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Gala Registration

You can with IACAN- Gala 2022 Registration

Saturday September 10th, 6:00PM, Sugarcreek Country Club

First Name *

Last Name *

Email Address *

Phone

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Gala Registration

Do you want to attend the event? *YesNo

Do you want to sponsor table (s)?YesNo

Sponsorship Options *Visionaries table $20,000Champions table $15,000Hope table $10,000Advocates table $5000

Event Ticket *Event Ticket ($500 per ticket)

Please state the number of event tickets you need ($500 per ticket) *

Attendee 2

First Name *

Last Name *

Email Address *

Phone

Street Address *

Apartment, suite, etc

City *

State/Province *

Meal Preferences *VegetarianNon vegetarian

Attendee 3

First Name *

Last Name *

Email Address *

Phone

Street Address *

Apartment, suite, etc

City *

State/Province *

Meal Preferences *VegetarianNon vegetarian

Attendee 4

First Name *

Last Name *

Email Address *

Phone

Street Address *

Apartment, suite, etc

City *

State/Province *

Meal Preferences *VegetarianNon vegetarian

Attendee 5

First Name *

Last Name *

Email Address *

Phone

Street Address *

Apartment, suite, etc

City *

State/Province *

Meal Preferences *VegetarianNon vegetarian

Attendee 6

First Name *

Last Name *

Email Address *

Phone

Street Address *

Apartment, suite, etc

City *

State/Province *

Meal Preferences *VegetarianNon vegetarian

Attendee 7

First Name *

Last Name *

Email Address *

Phone

Street Address *

Apartment, suite, etc

City *

State/Province *

Meal Preferences *VegetarianNon vegetarian

Attendee 8

First Name *

Last Name *

Email Address *

Phone

Street Address *

Apartment, suite, etc

City *

State/Province *

Meal Preferences *VegetarianNon vegetarian

Attendee 9

First Name *

Last Name *

Email Address *

Phone

Street Address *

Apartment, suite, etc

City *

State/Province *

Meal Preferences *VegetarianNon vegetarian

Attendee 10

First Name *

Last Name *

Email Address *

Phone

Street Address *

Apartment, suite, etc

City *

State/Province *

Meal Preferences *VegetarianNon vegetarian

Donate *

USD

Total Payment

Check Payment

I want to pay by check

Pay Later

Pay Later

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