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Payment for Banquet Deposit

Please enter information on this form to make payment for Banquet Deposit . The amount you need to pay is $500.00 .

First Name*

Last Name*

Organization

Phone*

Email*

Comment*

Amount*

Total Amount

$

Payment method

Credit Card via Paypal

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Type*

Card Holder Name*