High Holiday Reservations & Sponsorship Form


Personal Information:

Title:  
Last Name:
First Name:
Email:

Additional guest in your party

 We're old friends -You have my information!(skip next section) 

Address:
City:
State:
Zip:
Phone No:

Simchat Torah

Saturday Night Live, October 10

Adult   Child (2-11)

 

Sunday, October 11

Adult   Child (2-11)


Donations & Sponsorships

Sponsor $180

Co-Sponsor $100

   

I would like to dedicate  prayer book/s for $36 each

 

Other amount 

 

In honor memory of:


Payment Information:
Card Type:
Name on Card:
Card No:

CVV Security Code:

  What's This?
Expiration Date:  

Total Amount:


Comments:


 I will be mailing a check to Chabad Jewish Community Center, 3579 Arlington Ave., Suite 100, Riverside, CA 92506

 I would like to be added to the mailing list

Please click only once on the "Submit" button and wait a few seconds for acknowledgement online that your information was received.