2009 Wagner Banquet Registration Form

NOTE - The following form is for New York Law School students, faculty, and alumni to register for the 2009 Wagner Banquet. If you are a competitor, please contact wagnermoot@nyls.edu or call (212) 431-2175 for information on how to obtain tickets.

The deadline for Wagner Ball registrations is March 2, 2009.

Fee is $100 each

You may use this form to pay by credit card. This form uses 128-bit encryption and will encrypt your information as soon as it is submitted.

If you would like to pay by check, you must still fill out the registration form below and click the "submit" button to complete your registration. Please make the check out to New York Law School and submit payment to:

New York Law School, Moot Court Association
Attention: Gillian Kotlen & Adam Love
57 Worth Street, 8th Floor
New York, NY 10013

First Name
Last Name
Phone
E-mail
School Name
Name of guest(s)
Number Attending Wagner Banquet
Total Amount of Registration Fees (ex. "200")
Payment Method
Full Name (as appears on credit card)
Billing Address
City
State
Zip Code
Credit Card #
Month
Year
Check to authorize credit card use and enter charge amount below
I hereby authorize NYLS to charge my credit card for the amount of... (ex. "200")