Holiday Social & Foundation Benefit
Please use the form below to register for Lancaster City & County Medical Society's Holiday Social & Foundation Benefit scheduled for Saturday, December 5 at Lancaster Country Club (1466 New Holland Pike, Lancaster). You may also use the form to make a year-end donation to Lancaster Medical Society Foundation's scholarship fund.
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Practice/Workplace Affiliation (for name badge, if attending event)
Additional Attendees (please list additional registrants, if appropriate)
TICKET - LCCMS Member ($30)
Please Select
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TICKET - LCCMS Member Guest/NonMember ($60)
Please Select
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Optional Gift to Lancaster Medical Society Foundation
(100% will be added to the Scholarship Fund)
TOTAL AMOUNT TO BE CHARGED
Payment Amount
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( X )
USD
Description
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Submit
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