Torchbearers Induction Ceremony

Saturday, October 21, 2023 at Hardy Alumni Hall

Breakfast at 8:30 a.m. – Ceremony at 9 a.m.

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Registration Information

Kindly fill out this form to register yourself and any accompanying guests who will be attending with you.

Name*

First Last

Maiden Name

Please include if applicable.

Please select one:*

Class of*

Please enter all four digits of your class year. Use your most recent class year if you graduated more than once from Barton/Atlantic Christian College.

Email*

Primary Phone*

Please specify Home or Mobile below.

Phone Type*

Home Phone

Mobile Phone

Mailing Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Guest Information

Guests' Names

For the purpose of name tags, kindly provide the preferred full name of both yourself and your guests. (Limit of one guest per new/past inductee)

Breakfast and Ceremony for New Torchbearers Inductees

Complimentary per inductee and one guest

Breakfast and Ceremony for New Torchbearers Inductees

Complimentary per inductee and one guest

Breakfast and Ceremony for Past Torchbearers Inductees

@ $15 per person and one guest

Breakfast and Ceremony for Past Torchbearers Inductees

@ $15 per person and one guest

Total

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Security Code Cardholder Name

Confirm Cardholder Name*

Billing Address*

Street Address City State / Province / Region ZIP / Postal Code Country

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