Friday Evening Shabbat Dinner – RSVP "*" 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 Dinner Date*March 17, 2023Enter the number of reservations for adults and childrenAdults Quantity Price: $20.00 Quantity Children (3 - 12 yrs old) Quantity Price: $7.00 Quantity Attendees (List)Please list names of attendeesPlease consider making an additional donation to our Kiddush Fund. Donations at any level are appreciatedDonation Amount Total Payment InformationPayment Method* Charge my CC on file I will send a check to the CBI office Credit Card (Visa or MasterCard) Credit Card MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name Comments (Optional)Total
