2019 Gala Registration - Non-Credit Card Payment
If you are paying by Check, or Longwood Rotary Club dues (Longwood Rotary Members only), please fill in form below.
PAYMENT INSTRUCTIONS (CHECKS): Please make checks payable to LRF (Longwood Rotary Foundation), and mail with "Gala Ticket" in the memo line to: Longwood Rotary Foundation Gala, c/o Bob Listerman, PO Box 382, Kennett Square, PA 19348-1864.

Questions? Please email us at longwoodrotarygala@gmail.com. Thank you for supporting the Longwood Rotary Club, the Kennett Community, and beyond!

* Required

Email address *
Please Choose Payment Method *
Choose Ticket or Sponsorship Package *
Quantity of tickets or tables (as indicated above) *
Your First Name *
Your answer
Your Last Name *
Your answer
Your Email (preferred) Address for Confirmation *
Your answer
Your Mobile Phone Number (required to take part in the evening's activities) *
Your answer
Guest Names, Email Addresses, and Mobile Numbers - copy and paste here (preferred) or email to longwoodrotarygala@gmail.com. Type n/a if no guests. *
Your answer
Table Request - Please Indicate if there's anyone outside your party with whom you'd like to sit (or n/a) *
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms