BBNA Sneaker Ball 2024

Thank you for supporting the Birmingham Black Nurses Association!

Please complete the form below to register, and then submit your payment by Friday, October 31st via the following payment options:

Zelle: bbnatreasurer@gmail.com
Paypal: @birminghambna
venmo:@lonnitria-keenan

The deadline for table of 8 reservations is Monday, October 20th.

For questions, contact Lonntitria Keenan Harvell at Lkeenan2016@gmail.com

Your Name*

PrefixFirst NameLast NameSuffix

Email Address*

example@example.com

Phone Number

Please enter a valid phone number.

Are you bringing a guest?*

NoYes

Guest's Name

PrefixFirst NameLast Name

Are you purchasing a table of 8?*

NoYes

Are you a nursing student*

NoYes

Select the payment option you will use.*

ZelleVenmoCashappOther

What is your total payment being submitted? ex: Per person is $50, per person and guest is $100, table of 8 is $500, and nursing student is $30)

Attendee Information