Community Chanukah Party Sunday, November 28th, 4:00PM @ Chabad Full Name Email # of adults (at $15) Please Select 0 1 2 3 4 5 # of children (at $12) Please Select 0 1 2 3 4 5 no-one turned away from lack of funds. Donations appreciated Sponsor @ $100 or Any Donation Amount: TOTAL AMOUNT (charges plus donations if applicable) I would like to pay via: Check Credit Card At door 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 2019 2020 2021 2022 2023 2024 2025 CVV Street Address Apt # City Zipcode Phone Number 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.