Lilith Salon Series, 30s-50s Cohort
Sponsored by Women of Holy Blossom
Registration Information
First Name
Last Name
I am 30-50 years of age
Yes
No
Email Address
Phone number
How many additional guests will be joining you?
Please select...
0
1
2
3
4
Please select which worknights work best for you
Tuesday
Wednesday
Thursday
I would be willing to host Lilith Salon at my home
Yes
No
I will purchase a subscription to Lilith Magazine for the 2024 season
I would like to make a contribution to Women of
Holy Blossom
Contribution Details
Total Contribution
$
Please help us to offset credit card processing fees by contributing an additional 3%
Yes
No
Adjusted Total
3% Fee
$
Total Contribution
$
Please list your name(s) as you would like them to appear in the Temple Bulletin or write ‘anon’ if the gift is anonymous.
Credit Card Information
First Name
Last Name
Billing Address
Billing City
Billing Province
Please select...
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Billing Postal Code
Billing address must match the address associated with the credit card.
Credit Card Number
Visa or Mastercard
Expiry Month
Please select...
1
2
3
4
5
6
7
8
9
10
11
12
Expiry Year
Please select...
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
Tax Receipting
All donations will be tax receipted in February of the following year by email
Tax receipts will be issued for donations of $18 or more
Invoice Name
Authnet_Hidden_Fields
Invoice Req'd
Yes
No
Final Contribution
Thank you!
Thank you for your contribution towards Women of Holy Blossom. We are grateful for your support.
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Contact Information
