World Refugee Day Registration
Please register each guest below.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Would you like to make a gift to support the refugees living in our community?
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Buys household cleaning supplies for a refugee family
$
25.00
Quantity
1
2
3
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Aids in transporting refugee clients to health appointments
$
50.00
Quantity
1
2
3
4
5
6
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10
Helps a refugee complete a job readiness class
$
100.00
Quantity
1
2
3
4
5
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8
9
10
Provides a month of rent for a refugee
$
500.00
Quantity
1
2
3
4
5
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8
9
10
Credit Card Details (ENTER IF YOU ARE MAKING A DONATION)
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit Registration
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