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Test Registration
Home
Test Registration
Test Form
This is just a test form
Name
(Required)
First
Last
Email
(Required)
Enter Email
Confirm Email
Choose Event Registration Type
Test Event Registration (Single)
Test Event Registration (Multiple)
How would you like to pay?
Choose your payment type
Pay Now (Using Credit Card or PayPal Checkout)
Pay Later (Using Zelle)
Please make Zelle Payment of total Amount highlighted below to
info@mumineenrelief.org
. Please reference “
Gala Night
” in the memo.
Credit Card or PayPal
PayPal Checkout
Credit Card
MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number
Expiration Date
Security Code
Cardholder Name
Total