MEAL & SEAT RESERVATIONs First Name Last Name Address City State Zip Code Phone Email Adult Attendees 1 2 3 4 5 6 Children Attendees 0 1 2 3 4 5 6 Adult Name 1 Child Name 1 Adult Name 2 Child Name 2 Adult Name 3 Child Name 3 Yom Kippur Services I plan to attend: Please check all that apply Friday, September 29 Saturday, September 30 Kol Nidrei Evening Service (6:30 PM) Morning Service (10:00 AM) Yizkor Memorial Service (12:00 PM) Mincha (5:30 PM) Neilah Service (6:00 PM) Catered Break Fast Buffet (7:10 PM) Please join family and friends for our Yom Kippur Community Break-Fast. This year we are excited to have world-renowned Five-Star catering company, Danzinger Catering, providing the delicious buffet. Cost: $45 / adult | $25 / child Please select the number of attendees below Yom Kippur Break-Fast Saturday Sep. 30 # of Adults 1 2 3 4 5 6 7 8 9 # of Children 1 2 3 4 5 6 7 8 9 We thank you for your generosity and vision in helping us help others and provide this wonderful experience for the community. Please Choose $180 $360 $500 $1,000 $1,800 $3,600 $5,000 Other $ $10,000 - Elite Sponsor $5,400 - Platinum Sponsor $3,600 - Gold Sponsor $1,000 - Co-sponsor Yom Kippur Break-Fast $40 - Sponsor Tallit/s $36 - Sponsor Prayer Book/s Click here to dedicate a Yahrtzeit Plaque in honor of a loved one Click here to add a loved one to the list of Yizkor names Card Type Select American Express Discover Master Card Visa Card Number Expiration Month 1 2 3 4 5 6 7 8 9 10 11 12 Year 2013 2014 2015 2016 2017 2018 2019 2020 CVV Code Total Amount to Charge Card Comments Please click submit only once. Please wait a few seconds for acknowledgement online that your information was received. We will send you a receipt once your donation has been processed. Adult Name 3 Child Name 3 Adult Name 4 Child Name 4 Adult Name 5 Child Name 5 Adult Name 6 Child Name 6 This page uses 128 bit SSL encryption to keep your data secure.
