HANA Center's 2025 MODU Gala Registration: General Admission

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Contact Information

First Name Last Name

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Organization/Affiliation

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Ticket & Guest Information

Ticket Level		Quantity
Early Bird Ticket ($125)		`Number of Early Bird Ticket tickets ($125 each)`
$100 Donation ($100)		`Number of $100 Donation tickets ($100 each)`
$25 Donation ($25)		`Number of $25 Donation tickets ($25 each)`
$50 Donation ($50)		`Number of $50 Donation tickets ($50 each)`
5 Raffle Tickets ($20)		`Number of 5 Raffle Tickets tickets ($20 each)`
Raffle Tickets ($5)		`Number of Raffle Tickets tickets ($5 each)`
Additional Contribution (Optional)
TOTAL: $0		QTY: 0

If you were referred by a Host Committee member, organization, or friend, please enter their name here. This is so we can seat you together. (e.g., Jane Doe or "Company Name") (Optional)

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