Individual Registration

Please enter information in the form below to process registration for event جشن شب یلدا.

Ticket Information

Ticket Type	Price	Available Place	Quantity
Table A	S100.00	6
Table B	S100.00	6
Table C	S100.00	6
Table D	S100.00	7
Table E	S120.00	8
Table F	S100.00	8
Table G	S120.00	6
Table H	S120.00	8
Table I	S100.00	8
Table J	S100.00	8
Table K	S100.00	3
Table L	S100.00	8
Table M	S100.00	4
Table N	S100.00	8
Table O	S100.00	8
Table P	S100.00	8
Table Q	S100.00	8
Table R	S100.00	8
Table S	S100.00	8
Table T	S100.00	2
Table U	S100.00	5
Table V	S100.00	8

Billing Information

First Name *

Last Name *

Organization

Address

Address 2

City

Zip

Country *

State *

Phone

Email *

Payment Information

Coupon

Amount

S

Discount Amount

S

Payment Processing Fee

S

Gross Amount

S

Payment Method

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Holder Name*

info@ticketinfo.ca

(236) 509-8525

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