MINA Green Gala Ticket Registration

"*" indicates required fields

Step 1 of 2

Name*

First Last

Email*

Enter Email Confirm Email

Contact No.*

Company Name

Number of Tickets Needed*

Please fill out names of guests. If you do not have the names of your guests, please leave it as the default value.

Ticket 1 (Name)*

First Last

Ticket 2 (Name)

First Last

Ticket 3 (Name)

First Last

Ticket 4 (Name)

First Last

Ticket 5 (Name)

First Last

Ticket 6 (Name)

First Last

Ticket 7 (Name)

First Last

Ticket 8 (Name)

First Last

Total

Credit Card

Payment Method

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Credit Card

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