Villanova University Nursing Alumni Social at Yang Ming

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Please complete the following information. Required fields are marked with an asterisk (*). Are you a registered user? If you are a registered user, click the I'm Registered! button.??Your personal information and address will then be pulled from your profile and entered in the form below. Update my profile Update my information with the Villanova University Alumni Association with changes made on this form. Event Details Event title: ??Villanova?University?Nursing?Alumni?Social?at?Yang?Ming? Event date: ??February 28, 2013 6:30 PM Event end date: ??February 28, 2013 8:30 PM Location: ?? Yang?Ming?Restaurant 1051?Conestoga?Road?(at?Haverford?Road) Bryn?Mawr,?PA? 212-459-0643 Description: Come spend the evening with your fellow nursing alumni! Cost for this event is $25.00 per person and includes one drink and appetizers. Don't miss the chance to win one of two raffle baskets worth $75.00, courtesy of Atlantic Ambulatory Anesthesia Associates of Shrewsbury, NJ. Please contact Villanova Nursing Alumni Association Board Member Pat Somers '74 BSN and "85 MSN @ psomers@dh.org with questions. Register below. #?Attending ?@??$25.00 Total:$ View?Attendance?List Display my name in the attendance list for this event. Personal Information Title:?(Mr.,?Ms.,?etc.) First?Name:?* Middle?Name: Maiden?Name: Last?Name:?* Suffix:?(Jr.,?Sr.,?etc.) Email?Address?* Class Year: Please enter your phone number in the following format: xxx-xxx-xxxx. Daytime?Phone?Number: Evening?Phone?Number: Billing Address Street?Address1:?* Street?Address2: Street?Address3: City:?* State:?* Postal?Code:?* Country: Home Address Check if home address is same as your billing. Street?Address1:?* Street?Address2: Street?Address3: City:?* State:?* Postal?Code:?* Country:?* Guests Add?another?guest Payment Information Choose a payment option:?* Credit Card Name?as?it?appears?on?credit?card: Credit Card Type: Credit?Card?Number: Expiration Month: Expiration Year: CVN?Number: Confirmation Please take a moment to double check all of the information in your order for accuracy. If your information is correct, click the button below to submit your order. ???

Source: https://www.alumniconnections.com/olc/pub/VLN/event/showEventForm.jsp?form_id=145264

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