Weekend with Dr. Laz Reservation Form Name Address Phone Email 1. Movie Showing "Crown Heights" and Q&A with Dr. Laz - Thursday, February 6 7 pm @ CSU Behavioral Sciences Building Room #131 FREE OF CHARGE. Just show up and enjoy!! 2. Community Shabbat Dinner - Friday, February 7 6:30 pm @ CSU College of Business, 638 S. Sherwood St, Fort Collins # of Adults @ $12 Please Select 0 1 2 3 4 5 # of Children @ $8 Please Select 0 1 2 3 4 5 Sponsor @ $72 Weekend Sponsor @ $118 No-one turned away for lack of funds 3. Shabbat Lunch & Lecture - Saturday, February 8 10:00 am - Shabbat Services (optional); 12:00 pm - Lunch & Lecture @ Chabad - 1220G W. Elizabeth St. FREE of Charge # of Adults Please Select 0 1 2 3 4 5 # of Children Please Select 0 1 2 3 4 5 4. Concert - Saturday evening, February 8 8 pm @ CB & Potts Clubroom, 1415 W Elizabeth St, Fort Collins # of Adults @ $10 Please Select 0 1 2 3 4 5 Sponsor @ $54 Weekend Sponsor @ $118 Total Amount: I would like to pay via: Check Credit Card Card type: Please select Visa Mastercard American Express Card Number Exp. Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year 2013 2014 2015 2015 2016 2017 2018 2019 2020 CVV Please add 3% to my total to help cover credit card processing charges. This page uses 128 bit SSL encryption to keep your data secure.
