This is ONLY for registration with credit card payment for the A&R trip to Salem Haunted Happenings October 12, 2024. Special Note: The bus has a pick-up in East Hartford and New Britain, your choice, the bus company will notify you with more details. A&R Member's Full Name * Home e-mail Address * Cell Phone # * Number of Tickets ($86 each) * Total Payment Amount Type of Credit Card * - Select -VisaMastercardDiscoverAmerican Express By checking this box, I am agreeing to allow A&R to process payment from my listed card for tickets to this event. The charge may appear on your bill as "Am. Fed of Teachers" rather than A&R...it's how our account is set up, it is not a scam. * I agree Name On Credit Card * Street Address Associated With Credit Card * City Associated With Credit Card * ZIP Code Associated with Credit Card Credit Card Number Security Code * Expiration Date of Card * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202220232024202520262027202820292030 Leave this field blank
