C678 - Bowinn's Ugly Sweater Party: A Holiday Fundraiser

*We can only accept contributions for this event from individuals. Please include your name and residential address with your contribution. If you have any questions, wish to pay by cheque, or are a member of the Leader's Circle contact Emil at emil.hadad@bcndp.ca or 604-430-8600 x400

How many people are you registering? *

Your Registration Info

Email (Primary) *

First Name *

Last Name *

Phone

I declare *

Yes, I agree to the declaration below.

I declare that I am using my personal credit card to donate on my own behalf, and I am a BC resident and Canadian citizen or permanent resident.

Tickets

Regular Ticket *

CA$250.00
Enter # of tickets

Total for this participant

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

Name and Residential Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *