Havdallah in PJs

Registration Details

First Name

Last Name

Street Address

City

Postal Code

State

Phone

Number of Adults

Number of Children

Names of Everyone attending

Donation

Gan Families - FREE

Family Pricing (Immediate members only) - $ 0.00

- none -

Community Rates - $18 Per Family

Family Rate (Immediate members only) - $ 18.00

- none -

Be A Sponsor

Chai - $ 18.00

Double Chai - $ 36.00

Friend - $ 72.00

Gold - $ 180.00

- none -

Be a Sponsor - Other Amount

Total

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 *

info@stamfordchabad.org | 203-3CHABAD | 770 High Ridge Road Stamford, CT 06905-2308