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Wednesday, October 23, 2019
Capitale, 130 Bowery, New York, NY 10013
6 PM - 9 PM
Online registration closes at 5 p.m. on Friday, October 18th, 2019.
PRICE QUANTITY TOTAL

$25,000 12 0

$15,000 10 0

$8,500 6 0

$7,000 5 0

$5,500 4 0


* required
$2,500 4 0


* required
$300 0

$350 0


* required
$550 0

$600 0

$2,200 0

$1,600 0

$1,700 0

$800 0

$1,000 0

$500 0
                                                                 $
TOTAL DUE
You must select a registration item
0
Organization Name  
Please enter full organization name; do not use acronyms.
Contact First Name     Contact Last Name    
Contact Phone    
Email    
Confirm Email  
If known, please enter your guest names below. If you have additional names, need to make edits, or are unsure who will be attending right now, please email names to Lauren Jefferson at your earliest convenience.
Guest First Name Guest Last Name
Credit Card
Credit Card  
Card Number  
Expiration Date   MM        YY  
Card CVV2 Code
     Visa/MC: 3 digits in signature strip on back of card to the right of the (partial) card number.

Please note: We cannot accept payments by American Express at this time. If you cannot pay via Mastercard Or VISA, please pay via check instead.

To submit your payment, please click the button below only once. Please be patient while the transaction Is processing.

If you receive an error message, please contact Kimberly LaBeach.

You should receive an email upon completion of this page. Please note that some spam filters may intercept emails from the Network’s registration website. If you do not receive an email from us, it may be in your spam folder.
You should receive an email upon completion of this page. Please note that some spam filters may intercept emails from the Network’s registration website. If you do not receive an email from us, it may be in your spam folder.