Name(s)* Last Name* Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone Number*Email Address* Sunday, February 23 - Scott SingerBTC Men's Club member Free - Scott Singer Quantity Price: $0.00 Quantity BTC Men's Club non-member $10.00 - Scott Singer Quantity Price: $10.00 Quantity Sunday, April 19 - Jack BoekiBTC Men's Club member's Free - Jack Boeki Quantity Price: $0.00 Quantity BTC Men's Club non-member's $10.00 - Jack Boeki Quantity Price: $10.00 Quantity Sunday, May 17 - Congressman Ted DeutchBTC Men's Club member's Free - Ted Deutch Quantity Price: $0.00 Quantity BTC Men's Club non-member's $10.00 - Ted Deutch Quantity Price: $10.00 Quantity Total $0.00 Credit Card DiscoverMasterCardVisaSupported Credit Cards: Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name NameThis field is for validation purposes and should be left unchanged.
