Legal Aid Society - Acceptiva

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Take a pro bono case and attend FREE!
Please email Luc Louis Jacques at
LLouis-Jacques@legalaidocba.org

Qty

Description

Amount

Total

Ticket(s)

$150.00

---

(per person)

Total: $0.00

Guest Information

Please provide a Guest Name for each person attending as well as a Meal Choice.
If you are only staying for the Seminar please select Seminar Only as your meal choice.

All American Burger (with or without cheese)
Juicy ground beef patty served on a brioche bun with lettuces, tomato & onion/ fries/ fountain drink/ Lava cake.

Home Style Breaded Chicken Tender Fillets
With honey mustard/fries/fountain drink/Lava cake.

Aloma Signature Salad
Crisp lettuce, tomatoes, cucumbers, red onion slices, and black olives. Choice of dressings - Italian, ranch, Greek, blue cheese or balsamic. Lava cake.

Guest Name: *

Meal Choice: *

Payer Information

First Name: *

Last Name: *

Billing Address: *

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

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

Email: *

A receipt will be emailed to this address.

A COPY OF THE OFFICIAL REGISTRATION NUMBER 85-8012557303C-7/CH396 AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE 1-800-HELP-FLA (1-800-435-7352 WITHIN THE STATE OR BY VISITING THEIR WEBSITE AT www.FDACS.gov.. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *