EVENT IS SOLD OUT! Please do not fill out the form. Mother of Israeli Hostage Comes to Columbia Registration Form: AT THE CHABAD-ALEPH HOUSE WEDNESDAY, JANUARY 31 AT 7:00PM Name: Email: Phone: I would like to attend the "Mother of a Hostage speaks in Columbia" Please Check one: Price: $18 per person 1 Ticket: 2 Tickets: 3 Tickets: Sponsor with preferred seating $100/per person: 1 Sponsor Ticket 2 Sponsor Tickets: Special Student Pricing: Email [email protected] for info Other: I would like to help sponsor this event, Please add: $1000 $500 $360 $180 Other Amount: Payment: Please charge my credit card (CC info needed to submit form ) I will send a check to Chabad. Credit Card information: Visa Mastercard AmEx Name on card: Card Number: Expiration date: Security code: Zip Code: 100% of the proceeds of this donation or payment benefit Chabad of South Carolina, EIN 57-0841922 This page uses 128 bit SSL encryption to keep your data secure.