Chanukah Community Shabbat Dinner Friday Evening, May 5th 2017 Join us for a delightful and an enjoyable Shabbat Dinner with family and friends. ======================== RESERVATION FORM Contact Information Last Name First Name Address Phone Email Payment Information Adults: 0 1 2 3 4 5 6 7 8 9 10 $36 Per person Children 2-12: 0 1 2 3 4 5 6 7 8 9 10 $18 Per person $100 to Co-Sponsor in honor or in memory of a loved one. I would like to make a donation Other $ Charge Amount Card Type Please Select Visa Mastercard American Express Discover Card Number Expiration Date Month 01 02 03 04 05 06 07 08 09 10 11 12 Exp Year Year 2015 2016 2017 2018 2019 2020 2021 2022 CCV Code Comments This page uses 128 bit SSL encryption to keep your data secure.
