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I would like to join the Young Adults Shabbaton at Chabad of Uptown on March 14, 2008.

Title:  First Name:  Last Name:

Address: 

City, ST Zip:

Phone:  e-mail:

 

Please list names of attending guests (including self):

Guest #1:  Guest #2:

Guest #3: Guest #4:
If there are more than 4 guests please place names in "comments" box below.

I would like to be an Event Sponsor for only $180.

Comments: 


Please charge my credit card:   ($18 minimum)


Name on Card:
Card No.
Exp:mm/yyyy /
CVV Security Code: What's This? 

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We look forward to greeting you at the Shabbaton!!