Shabbat Across America March 1, 2013
Submit this form by February 21 and we will save a place for you!
Name
Phone
email
# of Adults @ $30
# of Children @ $15
# of Children under 5 (free)
# of Vegetarian Requests
Names of People Attending
If possible we would like to sit with
I will pay with PayPal below
I will call with crediit card
Please bill me.
I will send cash or check.
Pay Pal Payment
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Adults
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30.00
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Children
$
15.00
Number of Children
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Submit
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