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Holidays @ Chabad

Event Reservation and Payment Form

Event Reservation Form
Chabad of Putnam

For more information about our events Click here
Any Questions? Call our office at (845) 225-4770
Event Name*
Number of participants*
Contact Information
Full Name*
First NameLast Name
E-mail*
I would like to receive news and updates by email
Phone Number*
Area CodePhone Number
Payment Options
Event FeeTOTAL fee for ALL Participants or optional donation
$0
Event SponsorPlease use the notes below if there is someting in particular you would like to sponsor
$54$100$180$360
Total
$0.00
Yes, I'd like to donate the cost of processing this transaction by adding 3%

Payment

Credit Card Paypal Other

Postal / Zip Code

Country

Notes
Should be Empty:

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