RESERVATION INFORMATION
Name 
 Email address 
 Number of people attending 
 

Please select what type(s) of admission you would like to pay: 

 $10 tickets - How many?  

 I cannot attend but please accept my donation to Chabad of $
  Please email [email protected] for sponsorship opportunities. 
PAYMENT INFORMATION

  I will send a check 

Please mail to:
Chabad of West Hempstead 
411 Hempstead Turnpike, Suite L1 
West Hempstead NY 11552
  Please charge my credit card Amount to be charged 
$   
Credit card type 
  		 Credit card number  

Expiration date  
 

 Security code   

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