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ORDER FORM for "Group tickets"

- TICKETS / INFO

Group Tickets
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- Please fill in completely
  
  Parish/Church/Group Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number (requested) REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Group tickets
  
  ADULT TICKETS (price per ticket)45.0
  
  Number of Tickets REQUIRED Please fill out this field.
  
  Pay Online by credit card or
  Send your check to:
  Basilica of the Immaculate Conception
  74 W Main St, Waterbury, CT 06702
Total:

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