Dinner at Halo House
Thank you so much for considering our residents and caregivers. You will be contacted once we have received your submission.
Full Name
*
First Name
Last Name
Company/Group/Organization
E-mail
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
How many members are in your Group?
November 18th-24th at 6pm
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Month
-
Day
Year
Date
November 25th-December 1st at 6pm
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Month
-
Day
Year
Date
December 2nd-December 8th at 6pm
-
Month
-
Day
Year
Date
December 9th-December 15th at 6pm
-
Month
-
Day
Year
Date
December 16th-December 22nd at 6pm
-
Month
-
Day
Year
Date
December 23rd-December 29th at 6pm
-
Month
-
Day
Year
Date
December 30th- January 5th at 6pm
-
Month
-
Day
Year
Date
Any questions or more information we need to know?
Submit Form
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