Florida Night for Life RSVP
Florida Night for Life
The Country Club of Orlando
1601 Country Club Dr, Orlando, FL 32804
Wednesday,
November
13th, 2024
6 - 8 pm
Donation
Reservation
Florida Night For Life, $50 per person
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Florida Night for Life Table for 8, $400
Make a one-time donation
$
Donor Information
Last Name
*
First Name
*
Middle Name
Donor Address
Street Address
*
Street Address Line 2
City
*
State/Region
*
Select US-State
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GA - Georgia
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MP - Northern Mariana Islands
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PW - Palau
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VI - Virgin Islands
VT - Vermont
WA - Washington
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WY - Wyoming
Enter Region
Zip Code
*
Donor Contact Info
Home Phone
Enter International
Home Email
*
Payment Options
Payment Method
Credit Card
Check
Credit Card Information
Card information is sent directly to processor over encrypted connection and not stored in database.
Accepted Cards
Is Billing Address Different?
Credit Card Number
*
Credit Card Expiration Month
*
1 - January
2 - February
3 - March
4 - April
5 - May
6 - June
7 - July
8 - August
9 - September
10 - October
11 - November
12 - December
Credit Card Expiration Year
*
2025
2026
2027
2028
2029
2030
2031
2032
Credit Card Security Code (CVV)
*
Credit Card Billing Address
Street Address
*
City
*
State/Region
*
Select US-State
AK - Alaska
AL - Alabama
AR - Arkansas
AS - American Samoa
AZ - Arizona
CA - California
CO - Colorado
CT - Connecticut
DC - District of Columbia
DE - Delaware
FL - Florida
FM - Federated States of Micronesia
GA - Georgia
GU - Guam
HI - Hawaii
IA - Iowa
ID - Idaho
IL - Illinois
IN - Indiana
KS - Kansas
KY - Kentucky
LA - Louisiana
MA - Massachusetts
MD - Maryland
ME - Maine
MH - Marshall Islands
MI - Michigan
MN - Minnesota
MO - Missouri
MP - Northern Mariana Islands
MS - Mississippi
MT - Montana
NC - North Carolina
ND - North Dakota
NE - Nebraska
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NV - Nevada
NY - New York
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
PR - Puerto Rico
PW - Palau
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VA - Virginia
VI - Virgin Islands
VT - Vermont
WA - Washington
WI - Wisconsin
WV - West Virginia
WY - Wyoming
Enter Region
Zip Code
*
Guests
If you are reserving a table, please list the names of the guests that you are reserving it for. You're not required to enter all your guests at this time. You can email us at
info@nightlight.org
to register any remaining guests or make other changes.
Guests
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First Name
Last Name
Phone Number
Email
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