GCLA 2022 Annual Meeting & Awards Gala Registration Form

5:30PM - 6:30PM	Sponsor Appreciation Reception/Silent Auction
6:30PM - 8:00PM	Dinner
8:00PM - 8:30PM	Awards & Recognition
8:30PM - 10:00PM	Wine Auction & Dance Party

Name

First NameLast Name
Phone Number

Area CodePhone Number
E-mail
Name(s) (First & Last) and Email Address of Additional Guests that you are registering (if applicable)
Please select the category AND then the number of tickets you wish to purchase below.

Tickets

GCLA Member$150.00

Quantity

Non-Member$200.00

Quantity

Buy Out a Table$900.00

Seats 6

Quantity

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country