2019 Gala Registration All Ticket Sales are Final* Registration Deadline Date: October 31, 2019 Name* First Last LGA Class Year (Optional)Company Name Email* 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 ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name Billing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest 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
