Richfield Area Chamber of Commerce
             
Monthly Luncheon Registration

"Please enter the number of attendees for each date"
 
Business Name
January 12th:   $15.00   Quantity:   Item Subtotal:  
$0.00
February 9th:   $15.00   Quantity:   Item Subtotal:  
$0.00
March 9th:   $15.00   Quantity:   Item Subtotal:  
$0.00
April 20th:   $15.00   Quantity:   Item Subtotal:  
$0.00
May 11th:   $15.00   Quantity:   Item Subtotal:  
$0.00
June 8th:   $15.00   Quantity:   Item Subtotal:  
$0.00
July 13th:   $15.00   Quantity:   Item Subtotal:  
$0.00
August 10th:   $15.00   Quantity:   Item Subtotal:  
$0.00
September 14th:   $15.00   Quantity:   Item Subtotal:  
$0.00
October 12th:   $15.00   Quantity:   Item Subtotal:  
$0.00
December 14th:   $15.00   Quantity:   Item Subtotal:  
$0.00
Whole Year:   $165.00   Quantity:   Item Subtotal:  
$0.00
Total:
$0.00
Personal Information:
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone:
Email:
Payment Information:
Processing Fee Rates:
Cards:2.9% plus $0.30
eCheck:$0.55
Method of Payment:
 Update Name from Personal/Organizational Information
Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:
 Change Payment Method
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