First Fridays Shabbat Dinner! Last Name: First Name: Adults Attending: 0 1 2 3 4 5 6 7 8 Children Attending: 0 1 2 3 4 5 6 7 8 9 10 Sponsoring Yes, I would like to give $18 per adult and $15 per child Yes, I would like to be a sponsor for $180 Yes, I would like to be a sponsor for $360 Yes, I would like to be a sponsor for $540 I would like to sponsor a different amount: In honor of In memory of All contributions are tax-deductible Credit Card Information: Card Type: Please Select American Express Mastercard Visa Discover Pay by check Name On Card: Address: City: State: Zip: Phone: Email: Card Number: CVV Security Code: Expiration Date: Month: 01 02 03 04 05 06 07 08 09 10 11 12 Year: 25 26 27 28 29 30 31 32 Comments: This page uses 128 bit SSL encryption to keep your data secure.