Full Name*First NameLast NameE-mail*Phone Number*Area CodePhone NumberAdultsChildren*I want to sponsor$50 USD$75 USD$100 USDI'm coming on each of these dates*12/1/2019 - Chanukah Latkes & Lattes1/26/2020 - Tu B'Shvat Chocolate & Fruit Flower Arrangements2/23/2020 - Purim Hamantash Bake3/22/2020 - Passover Falafel & Pita4/26/2020 - Shavuot Dairy DelightsAll of the aboveTotal Charge$0.00 USDPayment MethodCredit Card Other Credit CardVisaMasterCardAmerican ExpressDiscoverCredit Card TypeCredit Card NumberSecurity CodeName on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberExpiration Month2019202020212022202320242025202620272028Expiration YearIf using CC on file put last 4 digits in special onstructions box. Check? Mail Check payable to ChabadComments? Questions?I would like to receive news and updates by emailSubmitShould be Empty: This page uses TLS encryption to keep your data secure.
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