Girl, GET UP! Conference
TALITHA CUMI CONFERENCE
Full Name
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First Name
Last Name
E-mail
*
example@example.com
Phone Number
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Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your primary reason(s) for attending this event?
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Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card.
Admission Ticket
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Exclusive Admission
(Includes 2-day Conference Admission, Conference T-shirt, Session Breakout, 3 Meals, Complimentary Gift)
$
150.00
General Admission
(Includes 1-day Conference Admission, Conference, Session Breakout and 2-Meal)
$
75.00
Session Breakout
*
Are you a Breast Cancer Survivor?
Yes
No
Are you currently a Breast Cancer Patient?
Yes
No
Payment Methods
Debit or Credit Card
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make your payment.
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