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Simchat Torah Form

I'd like to attend the Simchat Torah  on Monday, October 21 at (6:00 pm for children and) 7:00 PM for adults at the Chabad Aleph House

Suggested Donation:
$18 per Adult/$15 per child (Under 4 is free)
How many ppl? 

$50 per Family
Sponsor a family- How much? $       
  Other Information:

  * Denotes required field

Title*
First Name*
Last Name*
Address*
City*
State
Post Code*
Country*
Phone
This is my home business address.

 Total to charge my card: 

Card Type*
Card Number*
Expiration Date*
CVV Security Code

 

Email Address*
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Please contact me to discuss additional giving opportunities.
 Recurring donation:
Please charge the above amount to my credit card each month for the next twelve months.