Reservations I would like to reserve for:* Seder Night 1: March 27 8pm Seder Night 2: March 28 8pm Full Name* First Name Last Name E-mail* Phone Number* Area Code Phone Number Adults:* 1 2 3 4 5 6 7 8 9 Children 1 2 3 4 5 6 7 8 9 Suggested Donation: $50 Adults | $25 Children | $250 Matzah Sponsor | $360 Wine Sponsor | $540 Seder Sponsor Subsidized participation is available. Please contact the Rabbi in confidence if this charge is beyond your means. No one will be turned away due to lack of funds Total Amount* $ Payment* Credit Card Paypal Check Credit Card Visa MasterCard American Express Discover Credit Card Type Credit Card Number Security Code 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Expiration Month 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 Expiration Year Paypal has been selected. Payment will take place on the next page. Please mail check to: Chabad of Islip 102 E Main St Bay Shore, NY 11706 Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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