Board Registration/ 67th Military Ball

Grade

Name *

First

Last

Email (civilian)

Phone

Board Member Registration

NOTE: This is a complimentary Ticket to be paid for by NGAOK at $45 cost plus 19% gratuity and 5% Tax

Guest Name

First

Last

Seating Preference

Vegetarian Meal?

If YES, Please note the guest name below

Name

First

Last

Hair and Makup

Dropdown

Total Amount

$ 0.00

Credit Card

Card Number

Security Code

Name on Card

Expiration/

Please leave any comments or concerns that you may have