Rosh Hashana Community Dinner

Contact info

First Name *

Last Name *

Street Address *

City *

State *

Postal Code *

Email Address *

Phone *

Anything we need to know allergy related or otherwise?

How many adults?

How many children?

If you would like to share your birthday for a Jewish birthday reminder!

Birth Date

Dinner Donation

Sponsorship Options

Per Person Suggested - $ 45.00

Couple - $ 90.00

Child 1 (4-16) - $ 15.00

Child 2 (4-16) - $ 15.00

Donor - $ 180.00

Child 3 (under 4 free) - $ 0.00

Platinum Sponsor - $ 1,800.00

Not at this time - $ 0.00

If the check boxes above do not reflect your reservation accurately, please tally it up and put the amount here. You can leave the check boxes unchecked.

Other Amount-

Total

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

Allergies/questions/concerns?

Comments, questions, concerns, allergies

The Chabad Schneerson Center for Jewish Life, CT

info@schneersoncenter.org | 203.635.4118 | 228 Saugatuck Ave, Westport, CT 06880 Mailing address: 16 Railroad Place, Suite 770, Westport, CT 06880