Transitional Services for New York Inc. Take Me to Paris Registration

Register Below:

Name(Required)

Prefix First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Affiliated Organization

How did you find out about our events?

Would you like to attend the luncheon?(Required)

Yes, I would like to attend the event.

I cannot attend, but would like to make a contribution.

Event Ticket

Price: $75.00

How much would you like to contribute?(Required)

I'd like to help cover the transaction fees of 2.2% +.30 per transaction(Required)

Yes

Transaction fees:

Price: $0.00

Total

Payment Method

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name