2019 Gala Registration All Ticket Sales are Final* Registration Deadline Date: October 31, 2019 Name* First Last LGA Class Year (Optional)Company NameEmail* Enter Email Confirm Email Number of Tickets*1 - $150.002 - $300.003 - $450.004 - $600.00Guest #1 Name* First Last Guest #1 LGA Class Year (Optional)Guest 2 Name* First Last Guest 2 LGA Class Year (Optional)Guest 3 Name* First Last Guest 3 LGA Class Year (Optional)Total $0.00 Billing InformationName On Card* First Last Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Billing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please be sure to book your hotel on the next page after clicking "Submit"!* I understand
