Community Chanukah Party

Sunday, November 28th, 4:00PM @ Chabad


Full Name      Email 
# of adults (at $15)            
# of children (at $12)         
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:   Card Number  

Exp.          CVV   

Street Address   Apt #   City 


Phone Number 

 Please add 3% to my total to help cover credit card processing charges.