Inscription - Soirée Bénéfice - 16 novembre 2019


Date: 
2024-03-29
Number of Ticket(s)/Item(s): 
Amount: 
Total *: 
40,00
Vendeur *: 
Title: 
First Name *: 
Last Name *: 
Company/Corporation: 
E-Mail Address *: 
Address Line 1 *: 
Address Line 2: 
City *: 
Code Postal *: 
Province/State *: 
Country: 
Home Phone Number: 
Cell. Phone Number: 
Office Phone Number: 
Extension: 
Sign Me Up for Correspondence *: 
Message or Comments: 
Correspondence Language *: 
Keep my info: 





Selected Campaign
Soirée Bénéfice - 16 novembre 2019


Activity:

Entrée pour la Soirée (40$)

(Votre confirmation d'achat ou billet(s) vous sera transféré par courriel dans les prochaines heures)



Fields marked by (*) are mandatory.

N.B.: Please take note that PaySafe/Desjardins will send you an e-mail once your payment is confirmed. Thank You!