| Shopping Cart (1 Item) | ||
|---|---|---|
| 1 | BRONZE LEVEL SPONSOR | $300.00 |
| Subtotal: $300.00 Convenience Fee: $4.00 Total: $304.00 | ||
| E-Mail Address: | pur...@gmail.com |
|---|---|
| Billing First Name: | David |
| Billing Last Name: | Purdy |
| Billing Phone: | 217-520-6928 |
| Billing Address: | 3712 Hidden Circle |
| Billing City: | West Fargo |
| Billing State: | ND |
| Billing Zip: | 58078 |
| Shipping Address: | 3712 Hidden Circle |
| Shipping City: | West Fargo |
| Shipping State: | ND |
| Shipping Zip: | 58078 |