Friday Night Dinner with Rabbi Ken Spiro Registration

Friday Night Dinner with Rabbi Ken Spiro

First Name*

Last Name*

Email*

Phone*

Street*

Street 2 (Apt or Suite)

City*

State*

---select state---

Zip Code*

Adults, Members: $40

---select number of adults---

Children, Members (12 and under): Free

---select number of children---

Adults, Non- Members: $50

---select number of adults---

Children, Non- Members (ages 6-12): $10

---select number of children---

Children, Non- Members (under 6): Free

---select number of children---

Sponsorship Level

---Select Sponsorship Level---

Please list names (and ages of children) of any attending family members

Questions / Comments / Seat Requests (optional)

Would you like to cover the 3% processing fee for credit card payments?

Add processing fee

Card Type*

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Card Number*

Expiration Month*

---select month---

Expiration Year*

---select year---

CVV Code*

Total Amount $

1 time payment

12 monthly payments of $