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Roommate Option
(Required)
I have chosen a roommate and we are registering together
Patty can choose for me
Name
(Required)
First
Last
Email
(Required)
Roommate Registration
Roommate's Name
(Required)
First
Last
Roommate's Email
(Required)
Payment Options
Balance Due
(Required)
Price:
Balance Due with Roommate
(Required)
Price:
Total
This page is unsecured. Do not enter a real credit card number! Use this field only for testing purposes.
Payment Method
PayPal Checkout
Credit Card
MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number
Expiration Date
Security Code
Cardholder Name
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