First Name Last Name Address City State Zip Code Phone Email Affiliation Year Permanent Home Address Parent's Name Parent's Email Parent's Number Number of Adult Attendees 1 2 3 4 5 6 Number of Children Attendees 0 1 2 3 4 5 6 Adult Name 1 Child Name 1 Adult Name 2 Child Name 2 Adult Name 3 Child Name 3 Adult Name 4 Child Name 4 Adult Name 5 Child Name 5 Adult Name 6 Child Name 6 High Holiday Services I plan to attend Please check all that apply. Rosh Hashanah Eve. | September 18 Evening Service Rosh Hashanah Day 1 | September 19 Morning Service Rosh Hashanah Day 2 | September 20 Morning Service Second Shofar Service Third Shofar Service Yom Kippur | September 27 - 28 Kol Nidrei Service Morning Service Neilah Service Please select the number of attendees below Dinner - Friday, September 18 - to go only # of People 1 2 3 4 5 6 7 8 9 Lunch - Saturday, September 19 # of People 1 2 3 4 5 6 7 8 9 Dinner - Saturday, September 19 # of People 1 2 3 4 5 6 7 8 9 Lunch - Sunday, September 20 # of People 1 2 3 4 5 6 7 8 9 Yom Kippur Break Fast - Monday, September 28 # of People 1 2 3 4 5 6 7 8 9 I would like to pick up my meals to go. All that Chabad does, is only possible with the support of people like you, Parents, Alumni, Students, community members and friends. Help us, make this the best high holidays yet. Our budget is $54,000. Be a part of it, any amount make a impact. Please Choose $36 $54 $72 $180 $540 $1,000 Other $ Card Number Expiration Month 1 2 3 4 5 6 7 8 9 10 11 12 Year 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 CVV Code Total Amount to Charge Card This page uses 128 bit SSL encryption to keep your data secure.
