Health Expo Payment - Light Of The World Clinic

Community Health Expo Payment

We Accept All Major Credit Cards

Thank you for your support.

Please fill out the payment form below for our 12th Annual Community Health Expo on March 9th 2019. You may also call the clinic at (954)563-9876 to make your payment by phone.

Choose A Sponsorship

Or

Select A Vendor Registration Fee

Special instructions or needs

First Name

Last Name

Email Address

Company

Mobile Number

Company Phone Number

Billing Address

Billing Address Line Two

State/ Province

City

Zip Code

Country

Credit Card Number

Expiration Month

Expiration Year

Secret Code

Total

Total:

Your Tax deductible donation is greatly appreciated.

“A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE 1-800-HELP-FLA (435-7352) WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.”

www.FloridaConsumerHelp.com

Community Health Expo Payment

Thank you for your support.

Total:

Your Tax deductible donation is greatly appreciated.

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