Registration Form for Harc 2023 Gala and Auction

Gala Home | Purchase Tickets | View Auction Items

Don't miss out on this evening of excitement and elegance! Purchase individual tickets for you and your guests while supplies last.

You can also sponsor a whole table for you and seven of your friends and colleagues. As a table sponsor, you'll receive recognition in the event program and on the event website.

Event Ticket Information

Individual Ticket$175.00

Qty

Sub Total$0

Table$5,000.00

Qty

Sub Total$0

Contact Info

First Name

Last Name

Country

Address 1

Address 2

Postal Code

City

State/Province

Phone Number

Email Address

Yes, I would like to receive email communications.Yes, I would like to receive email communications.

Payment

Card Number

Card Type

Expiration Month

Expiration Year

Name On Card

CVV Code

Account Number

Routing Number

Name On Account

Account TypeCheckingSavings

Billing Address 1

Billing Address 2

Billing Postal Code

Billing City

Billing State

Billing Country