Shavuot

Shavuot Registration Form

First Name *

Last Name *

Street Address *

City *

State *

Postal Code *

Phone

Email *

Additional Participants

Please enter the names here.

Which event will you be attending: *

Morning event (10:15)

Afternoon event (5:30)

Help Sponsor this holiday (Optional donation)

Sponsorship Opportunities

Sponsor the entire holiday - $5,400

Benefactor - $1,800

Make a big difference - $1,000

Partner - $540

Donor - $180

Other Amount

Total

Authorize.net (Credit Card)

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

Info@ChabadSouthSI.org | 718-701-6419 | 592 Woodrow Rd