JWC Mega Challah Bake

How many people are you registering? *

Information

First Name *

Last Name *

Street Address *

City *

State *

Postal Code *

Phone *

Email *

If you would like to sit with anyone or would like to volunteer please include details below. If bringing a teen please include their details here too

Event Fee(s)

Early Bird Pricing (Exp May 8)

Other Donation Amount

Please enter in the number of Post Bas Mitzvah age girls you will be bringing

CTeen Rate (Bas Mitzvah age and above)

$18.00

Total for this participant

Authorize.net (Credit Card)

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

CHABAD OF STAMFORD - JEWISH CENTER FOR LIFE AND LEARNING