Freedom House Donation Form

Instructions: Please fill out the following form. After you complete the form you will recieve a donation confirmation confirmation. Note: Please keep a copy of this confirmation for your records. Customer Information * = Required Field
* First Name:	* Last Name:
Company:	Title:
* Address:	* City:
* State:	* Zip Code :
* Phone:	* Email:
Additional Information Accepted Payment Method: American Express, Discover, MasterCard, Visa
* Payment Method :	*Card Holder's Name :
* Exp. Date (MM/YY):	* Card Number :
* Donation Amount * Promo Code :	* Where did you hear about us?
	Other :
Terms and Conditions: By registering for a Freedom House event you are agreeing to these terms: Cancellations and Substitutions If you must cancel for any reason, you must notify us 3 business days prior to the event by writing to TChyb@freedomhousenj.org. No refunds are given however we will credit you an equal amount for another event. You may, however, transfer your registration to another person at any time. Please Note: Freedom House reserves the right to make changes to the events program. Unforeseen circumstances may result in the substitution of a presentation, topic or speaker. You consent to Freedom House recording and/or photographing the event and using such items, including your likeness, in future promotions. By purchasing a ticket, you also agree to allow us to share your contact information with exhibitors and sponsors of that event only. Freedom House will not otherwise sell or share your information with any other third parties without your consent. Freedom House reserves the right to reject or rescind any registration and return any fees accordingly. Registrant assumes all risks incidental to participation in all event activities, including, but not limited to, loss or damage to property and personal injury. Freedom House total liability in connection with participation in all event activities shall be limited to the amount of fees received, if any, from a particular individual registrant for the particular incident or event. If you have additional registration questions, please contact TChyb@freedomhousenj.org or call 908-537-6043.
I have read the above policy and agree to the conditions mentioned therein.