Fall GAYla Reserve your space TODAY!! 2023 Fall GAYla Reservation Form Name(Required) First Last Email(Required) PhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code How many guests will be attending, including yourself?(Required)Each table seats 8 people. I am unable to attend but would like to make a donation. 1 Guest - just myself 2 Guests 3 Guests 4 Guests 5 Guests 6 Guests 7 Guests 8 Guests - a FULL table! Donation(Required) 1 Ticket Price: 2 Tickets Price: 3 Tickets Price: 4 Tickets Price: 5 Tickets Price: 6 Tickets Price: 7 Tickets Price: 8 Tickets Price: If your table represents a group or organization, please type the name hereOPTIONAL Guest #2 Name(Required) First Last Guest #3 Name(Required) First Last Guest #4 Name(Required) First Last Guest #5 Name(Required) First Last Guest #6 Name(Required) First Last Guest #7 Name(Required) First Last Guest #8 Name(Required) First Last Total How will you be paying?(Required) CREDIT CARD CHECK All check payments are due by October 8, 2023 Paying with Check: Make check payable to The Phoenix Center, with the memo line "Fall GAYla" and mail to: The Phoenix Center 109 E. Lawrence Ave. Springfield, IL 62704 All check payments are due by October 7, 2022 Paying with Credit Card: Using SquareCredit Card Cardholder Name Card Details NameThis field is for validation purposes and should be left unchanged.
