Cocktails for Costumes Online Event Registration
Name(s)
Address
City
State
Zip code
Work Phone
Home Phone
E-mail
Number attending @ $50 per person Total $
I am unable to attend, please accept the enclosed donation of $ Select $50 $100 $150 $250 $500 $1,000 Other
If Other: $
to make a secure credit card payment.
Thank you for your support of Cocktails for Costumes and North Carolina Dance Theatre!
