Noche de Gala

The 2019 program will take place starting at 6 pm, Friday, June 7, 2019. It will be a Latin style celebration with an elegant dinner, dance, music and spirits. Pre-registration is required. Individual tickets are $75 per person. Beginning June 8, 2019: If you have not yet paid for Gala tickets please use this form.

Will you be attending? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

You Name (Guest 1) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

City / Town {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Zip Code {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Number of Attendee / Guest Tickets? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Sub-Total {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Table / Guest Registration

Guests check in by last name or by name of table host. We will notify guests of their table number in advance by email.

First Name

Last Name

Paid by guest, host or other?

Another Guest {binding ItemNumber}

First Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Paid by guest, host or other? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Table host or how did you hear about the Gala)? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Additional Donation - Join us in advancing Latino contributions to Southeastern Connecticut {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{{ ['Amigos - $50.00','President\u0027s Committee - $1,000.00','$100 Club - $100.00','Legacy Circle - $2,500.00','Benefactor - $500.00'][$index] }}

To complete your transaction PLEASE SIGN & PRESS the SUBMIT BUTTON below.

Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{~ Payment_Block_Label}

{binding Group}
{binding Name} - {binding Description}	{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}	{binding displayValue}
{binding Name}:	{binding displayValue}	---

{{ Cognito.resources['payment-amount-due'] + ":" }} {binding displayValue}

Noche de Gala

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}

{{ Cognito.resources['order-date-label'] }}: {binding displayValue}

{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{binding BillingName}

{binding BillingAddress.FullInternationalAddress}

{binding PhoneNumber}

{binding EmailAddress}

{binding Group}
{binding Name} - {binding Description}	{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}	{binding displayValue}
{binding Name}:	{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:	({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:	{binding displayValue}

Will you be attending? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

You Name (Guest 1) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

City / Town {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Zip Code {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Number of Attendee / Guest Tickets? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Sub-Total {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Table / Guest Registration

First Name

Last Name

Paid by guest, host or other?

Another Guest {binding ItemNumber}

First Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Paid by guest, host or other? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Table host or how did you hear about the Gala)? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Additional Donation - Join us in advancing Latino contributions to Southeastern Connecticut {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{{ ['Amigos - $50.00','President\u0027s Committee - $1,000.00','$100 Club - $100.00','Legacy Circle - $2,500.00','Benefactor - $500.00'][$index] }}

To complete your transaction PLEASE SIGN & PRESS the SUBMIT BUTTON below.

Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

The email has been sent.

Your progress has been saved.

Copy your form link:

Email me my link:

{ binding firstError.message }

Noche de Gala

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}

{{ Cognito.resources['order-date-label'] }}: {binding displayValue}

{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{binding BillingName}

{binding BillingAddress.FullInternationalAddress}

{binding PhoneNumber}

{binding EmailAddress}

{binding Group}
{binding Name} - {binding Description}	{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}	{binding displayValue}
{binding Name}:	{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:	({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:	{binding displayValue}

Will you be attending? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

You Name (Guest 1) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

City / Town {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Zip Code {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Number of Attendee / Guest Tickets? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Sub-Total {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Table / Guest Registration

First Name

Last Name

Paid by guest, host or other?

Another Guest {binding ItemNumber}

First Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Paid by guest, host or other? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Table host or how did you hear about the Gala)? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Additional Donation - Join us in advancing Latino contributions to Southeastern Connecticut {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{{ ['Amigos - $50.00','President\u0027s Committee - $1,000.00','$100 Club - $100.00','Legacy Circle - $2,500.00','Benefactor - $500.00'][$index] }}

To complete your transaction PLEASE SIGN & PRESS the SUBMIT BUTTON below.

Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Noche de Gala

Table / Guest Registration

Another Guest {binding ItemNumber}

{~ Payment_Block_Label}

Noche de Gala

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-billing-info-header'] }}

Table / Guest Registration

Another Guest {binding ItemNumber}

Your progress has been saved.

Noche de Gala

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-billing-info-header'] }}

Table / Guest Registration

Another Guest {binding ItemNumber}