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IAS PATRONS BALL
TICKET FORM

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Enter number of tickets:
Enter total US dollar amount:
* First Name
* Last Name
* Street Address (1)
Street Address (2)
* City
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Zip or Postal Code
* Country
* Language Spoken:
Home Telephone Number:
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* Your E-mail address
Your Church or Mission
Auditing Level:
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Membership Number (please enter only numbers with no spaces)

* Credit Card Type
* Credit Card Number
* CVV Number  ?:
* Expiration Date (MM/YYYY):
Comments:
I understand that I am making a payment for a ticket or tickets to an event sponsored by IAS Administrations. I understand that payments for tickets are not tax-deductible.


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