BJU College Trip
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Please List the Names of those Attending the BJU College Trip
List First and Last Name
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Payment
1 Attender ($30.00)
2 Attenders ($60.00)
1 Attender ($30.00)
2 Attenders ($60.00)
Amount
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
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NT
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NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
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VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
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