1 Start 2 Complete 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 * - Select -VisaMasterCardAmExDiscover 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. * I agree 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 * Leave this field blank
