CC Reservation – Credit Card 2025 Country Connection Registration Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email(Required) Phone(Required)Company Name (if applicable)I would like to reserve:(Required) A table for 8 A single ticket More than one ticket Table for 8 people (1 table is $1,200) QuantityValue of goods/services provided in return for this gift: $400. Enter number of tables below in the quantity box. Price: $1,200.00 Quantity Multiple Individual tickets at $150 each QuantityENTER THE NUMBER OF TICKETS YOU WOULD LIKE TO PURCHASE. Value of goods/services provided in return for this gift: $50 per ticket Price: $150.00 Quantity One Individual tickets at $150 QuantityValue of goods/services provided in return for this gift: $50 per ticket Price: $150.00 Quantity Total Please list the names of those who will be sitting at this table or using these tickets.TO ADD MORE NAMES Click on the + to add more lines. If you do not have all the names yet, we can check back with you later. If you are sitting at this table, please include your name on the list. First NameLast NameEmail address Add RemoveCredit Card InformationCredit Card(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name This is a secure donation site verified by Authorize.net. If you have any questions about this transaction, contact us via email or (423) 842-5757.NameThis field is for validation purposes and should be left unchanged.
