2024 Gala Virtual Tickets

NJCHS GALA 2024 | GENERAL REGISTRATION (Virtual Attendance)

*Unfortunately, we are required to assess a 3% processing fee for credit or debit card transactions, which is included in all prices listed on this form. If you would prefer to pay by check and avoid this fee, please download and complete this form.

"*" indicates required fields

Primary Guest Name*

First Last

Organization

Email*

Enter Email Confirm Email

IMPORTANT: To attend virtually, please enter the email address you will use to connect to Zoom.

Phone

Address

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

Virtual Access

Price: $25.75

Second Attendee's Information

First Last Email address

This field is only required for those purchasing multiple tickets.

Third Attendee's Information

First Last Email address

This field is only required for those purchasing multiple tickets.

Total

Credit Card*

Card Details

Cardholder Name

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