Leader’s Dinner

Ticket Purchase

This form can be used to purchase tickets for the Leader’s Dinner With Susan Holt event on May 20th, 2025.

Leader's Dinner Ticket(s)*

$500.00

Other

Other (Minimum $250.00)*

How many guests will be attending?*

There will be ten guests at each table.

How many guests will be attending?*

Please enter a number from 1 to 6.

There will be ten guests at each table.

I am purchasing these tickets to donate.

I am unsure who will be using these tickets

By clicking this box you will not be filling out information for your potential guests.

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Guest Information

If you are unsure who your guests will be, please type “TBA”.

Please fill out the following information for the guests that are attending with you.

Guest 1

Name*

First Last

Email

Dietary Restrictions

Guest 2

Name*

First Last

Email

Dietary Restrictions

Guest 3

Name*

First Last

Email

Dietary Restrictions

Guest 4

Name*

First Last

Email

Dietary Restrictions

Guest 5

Name*

First Last

Email

Dietary Restrictions

Guest 6

Name*

First Last

Email

Dietary Restrictions

Donation Information

Please select which riding you want to receive your donation. If you want the NBLA to receive the full donation, select NBLA.

Name*

Where would you like your donation to go?*

This field is hidden when viewing the form

Riding API ID

This field is hidden when viewing the form

Committee ID

Payment Information

Name*

First Last

Email*

Address*

Street Address Address Line 2 City Province Postal Code

Credit Card*

Please Confirm*

I am making this donation with personal NOT business/corporate funds. No entity will reimburse me.

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