YE-Newport, RI - DoYourOwnThing June 19, 2024

Credit Card Registration Form ONLY...if you are paying by check do NOT use this registration form

NEWPORT, RI - DYOT

June 19, 2024

$40.00 Per Person

Pick up is at 7:30 AM at the A&R Union Office Parking lot, located in the I-91 Tech Center, 805 Brook Street Rocky Hill, CT 06067.The Bus will leave Newport at 5:30PM

Name of A&R Employee

Home e-mail

Cell Phone #

Number of Tickets To Be Purchased

Total Cost For All Tickets at $40/ticket

Type of Credit Card

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.

Name on the Credit Card

Full Address Associated with the Credit Card

City associated with the Credit Card

State

ZIP Code associated with the Credit Card

Credit Card Number

Card Expiration Date - Use Format (MM/YY)

3 or 4 Digit Credit Card Security Code