Fundraising | SOUTHERN ONTARIO COCAINE ANONYMOUS (SOCA) CONVENTION

Bus Trip Registration

If you are human, leave this field blank.

STEP 1: Registration

Payment method (*Note: We cannot process Debit Cards) *

PayPal (Link Below)

E-Transfer

If you are sending an E-transfer, please submit your registration first, then send an E-transfer to SOCA Treasurer treasurer@socaconvention.org (make your security answer: soca2018)

Step 1: Registration *

$100 Deposit

$430 - Shared Occupancy

$620 - Single Occupancy

STEP 2: Payment

Total Amount $ *

Please see the prices to enter in STEP 1: Registration.

Card Details

Card Holder Name: *

Credit Card Number: *

Expiry date: *

CCV: *

STEP 3:

Your Name: *

Your full name.

Name tag to read:

Optional.

Home Group:

Optional but preferred.

Address

City

State/Province

Zip/Postal

Country

Phone Number *

Primary contact number.

Email Address *

Must be a valid email address.

STEP 4: Submit!

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