Chocolate Seder Women's Club 3rd Annual Chocolate Seder "*" indicates required fields Online ReservationName* First Last Email* Enter Email Confirm Email Phone*Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Seder PlatesEach seder plate set should have enough ingredients for one adult and 2-3 children.Number of Seder Plates Quantity* Price: $30.00 Quantity $25 per Seder Plate for Women’s Club Members, $30 for Non-Members *If you are a registered member of Women’s Club, you should have received an email with a discount code. If you have any questions, please contact the Office or cbiwomensclub@gmail.com. AttendeesPlease let us know how many people will be attendingAdults:*Please enter a number from 1 to 10.Children:Please enter a number from 0 to 10.Payment InformationWomen’s Club Discount Code Payment Method* Credit Card (Visa or MasterCard) I will send a check to CBI Credit Card MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name Total