Old Dominion University

Wednesday, October 13^th, 2021
Norfolk Yacht and Country Club
6:00PM Social Hour
7:00PM Dinner & Presentations

Registration

Qty

Description

Amount

Total

Reservation(s)

$100.00

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Reservations - Table of 8

$750.00

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Total: $0.00

Guest Information

Guest #1: *

Payer Details

ODAF Member #

First Name: *

Last Name: *

Are You An ODU Alumnus?

Class Year:

If so, please enter class year.

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Home Telephone:

Business Telephone:

E-mail: *

A receipt will be e-mailed to this address.

Additional Comments:

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *