You are registering for :

Event Details:

Current Registration Status

Event Format

VirtualIn-PersonHybrid

Attendee Information

First Name

Last Name

Pronouns

Email Type

PersonalWork

How are you planning to attend?

In-PersonLive Stream

Attendance type

Shows a values for attendance type regardless of conidtional questions

Any food restrictions we should know about?

VegetarianVeganGluten Free

Are you planning to bring any guests with you?

YesNo

Original Participant

Total number of guests (Not including you)

Total number of attendees

Guest Information

Please enter your guest(s)' name(s).

Guest 1 full name

Guest 2 full name

Guest 3 full name

Guest 4 full name

Support ILALI!

Subscribe to ILALI newsletter for more local events

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All proceeds from this event will go towards the rebuilding of our beloved community space.

Just so you are aware, the local patron option is the fair market value of the offering we're putting forth. Any ticket tier above that option will provide a tax deductible donation receipt for however much the amount is beyond the value of the local patron option.

The ticket prices are per person, and will calculate per the number of participants you entered above.

Thank you for your generosity and participating in this joyous occasion to rebuild our organizational home base!

Local Patron: $

Supportive Sustainer: $

Radical Regenerator: $

Please select your ticket tier:

Local PatronSupportive SustainerRadical RegeneratorName your contribution

Contribution Amount: $

Please enter numbers only.

Selected Price

Reg. Fee

How much is the official registration fee out of the options - the lowest tier

Total Reg. Fee

Official registration fee times the total number of participants

Total Fee Portion

Out of the total amount due what is earned income - what is the fee portion?

Total Donation

Out of the total amount due what is donation portion?

Total Amount Due $

Number of tickets included

Show Registration Payment Section

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Payment Information

Credit Card Number

Expiration Month (##)

Expiration Year (##)

CVC (###)

Full Name on Card

Cardholder's Country

Selected country

Cardholder's Address

Cardholder's City

Cardholder's state

Cardholder's State/Province

Cardholder's Zipcode

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Event ID (Note: This is a unique Salesforce record ID)

Event No.

Please click submit only once. After the form is processed you should receive a confirmation email at the address you provided above.