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                      <p style="color: rgb(103, 54, 14); font-family: tahoma; font-size: 16px; line-height: 1.2; font-weight: bold;" class="style7">High Holiday Reservation Form</p>
<p style="color: rgb(103, 54, 14); font-family: tahoma; font-size: 10pt; line-height: 1.2;" class="style5">We hope you are planning to join us at the Chabad for a joyous, uplifting and spiritual High Holiday experience this Rosh Hashanah and Yom Kippur. Please complete the form for High Holiday Seats below. </p>
<p style="color: rgb(103, 54, 14); font-family: tahoma; font-size: 10pt; line-height: 1.2;" class="style5">While we do not have set membership fees, we encourage you to donate and be part of Friends of Chabad.</p>
<p style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; line-height: 1.2;"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style5">I look forward to greeting you on Rosh Hashanah and anticipate an inspiring and spirited High Holiday season.   
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<br>
 Best wishes for a Happy and Healthy Sweet New Year   
<br>
<br>
 Rabbi Mendel Shemtov</span></p>
<p style="font-family: tahoma; font-size: 10pt; line-height: 1.2;" class="style5"><span style="color: rgb(103, 54, 14);">For more information please call</span> <font color="#0033BB"><u><span class="skype_c2c_print_container">847.440.4486</span></u></font> <font color="#67360E">or <a style="color: rgb(0, 79, 157); outline: none; text-decoration: none;" href="mailto:rabbi@elginchabad.com">email us.</a></font>
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<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Address</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style5"><input type="text" name="x_address" required="true" tabindex="3">  </span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"> </td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">City</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><input type="text" name="x_city" required="true" tabindex="4"></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"> </td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">State/Zip</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 60px; height: 22px;" name="x_state" required="true" size="7" tabindex="5">  / <input type="text" style="width: 83px; height: 22px;" name="x_zip" required="true" size="10" tabindex="6"></span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"> </td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Phone</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style5"><input type="text" name="x_phone" required="true" tabindex="7">  </span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"> </td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Email</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style5"><input type="text" name="x_email" required="true" tabindex="8">  </span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"> </td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="5"> </td>
                  </tr>
<tr>
                    <td bgcolor="#D8B876" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="5"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style4 style2 style1 style68"><strong>Adult/Children High Holiday Reservations</strong></span></td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Adults</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><select style="width: 170px;" name="HH adult reservations" tabindex="9"><option selected value="How many Adults?">How many Adults?</option>
                          <option value="1">1</option>
                          <option value="2">2</option>
                          <option value="3">3</option>
                          <option value="4">4</option>
                          <option value="5">5</option>
                          <option value="6">6</option></select></span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6">Children <select name="HH" reservations="" children="" size="1" tabindex="10"><option value="How many Children?" selected>How many Children?</option>
                          <option value="1">1</option>
                          <option value="2">2</option>
                          <option value="3">3</option>
                          <option value="4">4</option>
                          <option value="5">5</option>
                          <option value="6">6</option></select>  </span></td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Adult Name 1</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 168px; height: 22px;" name="Adult name1" required="false" size="21" tabindex="11"></span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 170px; height: 22px;" name="child name1" required="false" size="21" tabindex="13">  </span></td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Adult Name 2</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 170px; height: 22px;" name="Adult name2" required="false" size="22" tabindex="11"></span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 171px; height: 22px;" name="child name2" required="false" size="22" tabindex="13">  </span></td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Adult Name 3</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 168px; height: 22px;" name="Adult name3" required="false" size="21" tabindex="11"></span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 172px; height: 22px;" name="child name3" required="false" size="22" tabindex="13">  </span></td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Adult Name 4</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 169px; height: 22px;" name="Adult name4" required="false" size="22" tabindex="11"></span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><input type="text" style="width: 171px; height: 22px;" name="child name4" required="false" size="22" tabindex="13"></td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Adult Name 5</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 169px; height: 22px;" name="Adult name5" required="false" size="22" tabindex="11"> </span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 173px; height: 22px;" name="child name5" required="false" size="22" tabindex="13">  </span></td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Adult Name 6</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 170px; height: 22px;" name="Adult name6" required="false" size="22" tabindex="11"></span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 173px; height: 22px;" name="child name6" required="false" size="22" tabindex="13">  </span></td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="5"> </td>
                  </tr>
<tr>
                    <td bgcolor="#D8B876" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="5"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style68 style1 style2 style4"><strong>High Holiday Services I plan to attend:</strong></span></td>
                  </tr>
<tr>
                    <td bgcolor="#F5EDDC" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="5">
                      <p style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; line-height: 16.363636016845703px;"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4"><br></span></p>
<table width="572" cellspacing="0" cellpadding="5" border="0" align="center" style="" dir="ltr">
                        <tbody>
                          <tr>
                            <td height="15" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="4"><strong style="font-family: Helvetica, Arial, sans-serif; font-size: 13px; color: rgb(125, 76, 17); padding: 4px; line-height: 16px;" class="text">High Holiday Services I plan to attend</strong> <em style="font-family: Helvetica, Arial, sans-serif; font-size: 13px; color: rgb(198, 155, 103); font-weight: bold; border: none; padding-left: 4px; padding-right: 4px;" class="notes"><br>
 Please check all that apply.</em></td>
                          </tr>
<tr>
                            <td width="24%" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: Helvetica, Arial, sans-serif; font-size: 12px; color: rgb(125, 76, 17); line-height: 16px;" class="fieldname"><strong>Rosh Hashanah Eve.</strong> September 24</span></td>
                            <td width="26%" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><strong style="font-family: Helvetica, Arial, sans-serif; font-size: 12px; color: rgb(125, 76, 17); line-height: 16px;" class="fieldname">Rosh Hashanah Day 1  
<br></strong> <span style="font-family: Helvetica, Arial, sans-serif; font-size: 12px; color: rgb(125, 76, 17); line-height: 16px;" class="fieldname">September 25</span></td>
                            <td width="25%" height="15" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: Helvetica, Arial, sans-serif; font-size: 12px; color: rgb(125, 76, 17); line-height: 16px;" class="fieldname"><strong>Rosh Hashanah Day 2
<br></strong> September 26</span></td>
                            <td width="25%" height="15" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: Helvetica, Arial, sans-serif; font-size: 12px; color: rgb(125, 76, 17); line-height: 16px;" class="fieldname"><strong>Yom Kippur  
<br></strong> October 3 and 4</span></td>
                          </tr>
<tr>
                            <td width="24%" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><input type="checkbox" value="on" name="Rosh Hashanah (9/16) Evening Service" id="Rosh Hashanah Day 1 Evening Service"> <label style="font-family: Helvetica, Arial, sans-serif; font-size: 12px; color: rgb(125, 76, 17); line-height: 16px;" for="Rosh Hashanah Day 1 Evening Service" class="fieldname">Evening Service</label></td>
                            <td width="26%" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><input type="checkbox" value="on" name="Rosh Hashanah Day 1 Morning Service" id="Rosh Hashanah Day 1 Morning Service"> <label style="font-family: Helvetica, Arial, sans-serif; font-size: 12px; color: rgb(125, 76, 17); line-height: 16px;" for="Rosh Hashanah Day 1 Morning Service" class="fieldname">Morning Service</label></td>
                            <td width="25%" height="15" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><input type="checkbox" value="on" name="Rosh Hashanah Day 2 Morning Service" id="Rosh Hashanah Day 2 Morning Service"> <label style="font-family: Helvetica, Arial, sans-serif; font-size: 12px; color: rgb(125, 76, 17); line-height: 16px;" for="Rosh Hashanah Day 2 Morning Service" class="fieldname">Morning Service</label></td>
                            <td width="25%" height="15" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><input type="checkbox" value="on" name="Yom Kippur Kol Nidrei" id="Kol Nidrei Service"> <label style="font-family: Helvetica, Arial, sans-serif; font-size: 12px; color: rgb(125, 76, 17); line-height: 16px;" for="Yom Kippur Kol Nidrei" class="fieldname">Kol Nidrei Service</label></td>
                          </tr>
<tr>
                            <td width="24%" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"> </td>
                            <td width="26%" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"> </td>
                            <td width="25%" height="15" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"> </td>
                            <td width="25%" height="15" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><input type="checkbox" value="on" name="Yom Kippur Morning Service" id="Yom Kippur Morning"> <label style="font-family: Helvetica, Arial, sans-serif; font-size: 12px; color: rgb(125, 76, 17); line-height: 16px;" for="Yom Kippur Morning" class="fieldname">Morning Service</label></td>
                          </tr>
<tr>
                            <td bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"> </td>
                            <td bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"> </td>
                            <td height="15" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"> </td>
                            <td height="15" bgcolor="#F6F3EE" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><input type="checkbox" value="on" name="Yom Kippur Mincha &amp; neilah service" id="Yom Kippur Neilah Service"> <span style="font-family: Helvetica, Arial, sans-serif; font-size: 12px; color: rgb(125, 76, 17); line-height: 16px;" class="fieldname">Neilah  <label for="Yom Kippur Neilah Service">Service</label></span></td>
                          </tr>
                        </tbody>
                      </table>
<p style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; line-height: 16.363636016845703px;"> </p>
                    </td>
                  </tr>
<tr>
                    <td bgcolor="#D8B876" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="5"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style4 style2 style1 style68"><strong>Rosh Hashanah Dinner</strong></span></td>
                  </tr>
<tr>
                    <td bgcolor="#F5EDDC" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="5">
                      <p style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; line-height: 16.363636016845703px;"><span style="color: rgb(153, 51, 0); font-size: 14px;">You are cordially invited to join us for a delicious Rosh-Hashanah meal  together with family and friends.</span></p>
<p><span style="color: rgb(153, 51, 0);">Just what the Chabad of Community has been <img hspace="10" align="left" alt="" real_height="126" real_width="100" src="http://www.chabadbeaches.com/media/images/5729.jpg">waiting for, a Rosh Hashana Dinner. Following Services on the 1st  Night of Rosh Hashana, September 24th, Chabad of Elgin will host a Traditional Rosh Hashana meal. Guests will love the delicious gourmet food, which will include all of the holiday favorites, as well as many Rosh Hashanah delicacies.</span> </p>
<table width="100%" cellspacing="0" cellpadding="2" border="0" dir="ltr" style="border-collapse: collapse;">
                        <tbody>
                          <tr>
                            <td width="33%" height="15" colspan="3"><input type="checkbox" name="I would like to join the RH Dinner" tabindex="1"> <span style="font-size: 14px; color: rgb(153, 51, 0);"><strong>Yes, I would like to join the Rosh Hashanah Dinner</strong></span></td>
                          </tr>
<tr>
                            <td width="33%" height="15" colspan="3">     <span style="color: rgb(153, 51, 0);"><strong><span style="font-size: 14px;">$25 Adults</span></strong></span> <select name="Rosh" size="1" tabindex="1"><option value="Adults Attending" selected>Adults Attending</option>
                                <option value="1">1</option>
                                <option value="2">2</option>
                                <option value="3">3</option>
                                <option value="4">4</option>
                                <option value="5">5</option>
                                <option value="6">6</option>
                                <option value="7">7</option>
                                <option value="8">8</option>
                                <option value="9">9</option>
                                <option value="10">10</option></select><span style="color: rgb(153, 51, 0);"><strong><span style="font-size: 14px;">$10 Child</span></strong></span> <select name="Children" attending="" rh="" dinner="" size="1" tabindex="1"><option value="Children Attending">Children Attending</option>
                                <option value="1">1</option>
                                <option value="2">2</option>
                                <option value="3">3</option>
                                <option value="4">4</option>
                                <option value="5">5</option>
                                <option value="6">6</option>
                                <option value="7">7</option>
                                <option value="8">8</option>
                                <option value="9">9</option>
                                <option value="10">10</option></select></td>
                          </tr>
<tr>
                            <td width="33%" height="15" colspan="3"><span style="color: rgb(153, 51, 0);"><strong> <input type="checkbox" name="Sponsor $180 RH Dinner" tabindex="1"></strong><span style="font-size: 14px;"><strong>Sponsor the Rosh Hashanah Dinner for $180 </strong></span></span></td>
                          </tr>
                        </tbody>
                      </table>
                    </td>
                  </tr>
<tr>
                    <td bgcolor="#D8B876" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="5"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style4 style2 style1 style68"><strong>Yizkor Memorial Booklet
<br></strong></span></td>
                  </tr>
<tr>
                    <td bgcolor="#F5EDDC" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="5">
                      <p style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; line-height: 16.363636016845703px;"><strong><span style="color: rgb(153, 51, 0);">$18 Per Name</span></strong><span style="color: rgb(153, 51, 0);"> 
<br></span></p>
<table width="95%" cellspacing="0" cellpadding="7" border="0">
                        <tbody>
                          <tr>
                            <td bgcolor="#F9F3E8" colspan="2" class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><strong class="style11" style="font-size: 13px; color: rgb(103, 54, 14);">Loved One #1</strong></td>
                          </tr>
<tr>
                            <td width="50%" class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span style="color: rgb(103, 54, 14);">Loved Ones Name   
<br></span> <span class="style4 style26" style="font-weight: bold; color: rgb(103, 54, 14);"><input type="text" name="Loved Ones Name" required="false" size="23" tabindex="26" id="Loved Ones Name" style="width: 185px; height: 22px;"></span></td>
                            <td width="50%" class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span style="color: rgb(103, 54, 14);">Loved Ones Father's Name <input type="text" name="Loved Ones Fathers Name" required="false" size="27" tabindex="26" id="Loved Ones Fathers Name" style="width: 185px; height: 22px;"></span></td>
                          </tr>
<tr>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span class="style14" style="color: rgb(103, 54, 14);">Your Relationship to Loved One</span><span style="color: rgb(103, 54, 14);"><input type="text" name="Your Relationship to Loved One" required="false" size="23" tabindex="27" id="Your Relationship to Loved One" style="width: 185px; height: 22px;"></span></td>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span style="color: rgb(103, 54, 14);">Date of Passing [MM/DD/YY] <input type="text" name="Date of Passing" required="false" size="27" tabindex="27" id="Date of Passing" style="width: 185px; height: 22px;"></span></td>
                          </tr>
<tr>
                            <td bgcolor="#F9F3E8" colspan="2" class="style11" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-weight: bold; color: rgb(103, 54, 14);">Loved One #2</td>
                          </tr>
<tr>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span style="color: rgb(103, 54, 14);">Loved Ones Name   
<br></span> <span class="style4 style26" style="font-weight: bold; color: rgb(103, 54, 14);"><input type="text" name="Loved One2_Name" required="false" size="23" tabindex="28" id="Loved One2_Name" style="width: 185px; height: 22px;"></span></td>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span style="color: rgb(103, 54, 14);">Loved Ones Father's Name <input type="text" name="Loved One2_Father's Name" required="false" size="27" tabindex="28" id="Loved One2_Father's Name" style="width: 185px; height: 22px;"></span></td>
                          </tr>
<tr>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span class="style14" style="color: rgb(103, 54, 14);">Your Relationship to Loved One</span><span style="color: rgb(103, 54, 14);"><input type="text" name="Your Relationship to Loved One2" required="false" size="23" tabindex="29" id="Your Relationship to Loved One2" style="width: 185px; height: 22px;"></span></td>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span style="color: rgb(103, 54, 14);">Date of Passing [MM/DD/YY] <input type="text" name="Date of Passing_Loved one2" required="false" size="27" tabindex="29" id="Date of Passing_Loved one2" style="width: 185px; height: 22px;"></span></td>
                          </tr>
<tr>
                            <td bgcolor="#F9F3E8" colspan="2" class="style11" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-weight: bold; color: rgb(103, 54, 14);">Loved One #3</td>
                          </tr>
<tr>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span style="color: rgb(103, 54, 14);">Loved Ones Name   
<br></span> <span class="style4 style26" style="font-weight: bold; color: rgb(103, 54, 14);"><input type="text" name="Loved One3_Name" required="false" size="23" tabindex="30" id="Loved One2_Name0" style="width: 185px; height: 22px;"></span></td>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span style="color: rgb(103, 54, 14);">Loved Ones Father's Name <input type="text" name="Loved One3_Father's Name" required="false" size="27" tabindex="31" id="Loved One2_Father's Name0" style="width: 185px; height: 22px;"></span></td>
                          </tr>
<tr>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span class="style14" style="color: rgb(103, 54, 14);">Your Relationship to Loved One</span><span style="color: rgb(103, 54, 14);"><input type="text" name="Your Relationship to Loved One3" required="false" size="23" tabindex="32" id="Your Relationship to Loved One3" style="width: 185px; height: 22px;"></span></td>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span style="color: rgb(103, 54, 14);">Date of Passing [MM/DD/YY] <input type="text" name="Date of Passing_Loved one3" required="false" size="27" tabindex="34" id="Date of Passing_Loved one3" style="width: 185px; height: 22px;"></span></td>
                          </tr>
<tr>
                            <td bgcolor="#F9F3E8" colspan="2" class="style11" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-weight: bold; color: rgb(103, 54, 14);">Loved One #4</td>
                          </tr>
<tr>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span style="color: rgb(103, 54, 14);">Loved Ones Name   
<br></span> <span class="style4 style26" style="font-weight: bold; color: rgb(103, 54, 14);"><input type="text" name="Loved One4_Name1" required="false" size="23" tabindex="36" id="Loved One2_Name1" style="width: 185px; height: 22px;"></span></td>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span style="color: rgb(103, 54, 14);">Loved Ones Father's Name <input type="text" name="Loved One4_Father's Name" required="false" size="27" tabindex="37" id="Loved One2_Father's Name1" style="width: 185px; height: 22px;"></span></td>
                          </tr>
<tr>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span class="style14" style="color: rgb(103, 54, 14);">Your Relationship to Loved One</span><span style="color: rgb(103, 54, 14);"><input type="text" name="Your Relationship to Loved One4" required="false" size="23" tabindex="38" id="Your Relationship to Loved One4" style="width: 185px; height: 22px;"></span></td>
                            <td class="style3" style="font-family: tahoma; border: 1px dotted rgb(211, 211, 211); font-size: 11px;"><span style="color: rgb(103, 54, 14);">Date of Passing [MM/DD/YY] <input type="text" name="Date of Passing_Loved one4" required="false" size="27" tabindex="39" id="Date of Passing_Loved one4" style="width: 185px; height: 22px;"></span></td>
                          </tr>
                        </tbody>
                      </table>
<p style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; line-height: 16.363636016845703px;"> </p>
                    </td>
                  </tr>
<tr>
                    <td bgcolor="#D8B876" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="5"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style4 style2 style1 style68"><strong>Sponsorship Opportunities</strong></span></td>
                  </tr>
<tr>
                    <td bgcolor="#F5EDDC" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="5">
                      <p style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; line-height: 16.363636016845703px;"><span style="color: rgb(153, 51, 0);">Sponsor a Machzor Prayerbook: $36  </span></p>
<p style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; line-height: 16.363636016845703px;"><span style="color: rgb(153, 51, 0);">You may dedicate your contribution or the Machzor prayerbook(s) to a loved one, family or friend.</span></p>
<p style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; line-height: 16.363636016845703px;"><span style="color: rgb(153, 51, 0);"><input type="radio" value="In memory of" name="Memory"> <strong>In Memory of</strong>  
<br>
 Make a donation in memory of a deceased family member or friend.  
<br>
 <img width="1" height="6" src="https://www.mychabad.org/images/global/spacer.gif" alt="">  
<br>
 <input type="radio" value="In honor of" name="Memory"> <strong>In Honor of</strong>  
<br>
 Make a donation in honor of someone or to celebrate a joyous occasion.</span></p>
<p align="left" style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; line-height: 16.363636016845703px;"><span style="color: rgb(153, 51, 0);">Details: </span></p>
<p style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; line-height: 16.363636016845703px;"> <textarea style="margin: 1.80398px; width: 416px; height: 68px;" required="false" tabindex="1" name="Details"></textarea></p>
                    </td>
                  </tr>
                </tbody>
              </table>
<table width="619" cellspacing="8" cellpadding="6" bgcolor="E7DFCF" align="center" dir="ltr" style="border: 3px solid rgb(134, 172, 191);">
                <tbody>
                  <tr>
                    <td width="20%" height="15" bgcolor="#D8B876" style="text-align: left; font-family: Arial; font-size: 10px;" colspan="4"><span style="font-size: 20px; color: rgb(173, 80, 14);"><strong><span style="color: rgb(173, 80, 14);">Donation:</span></strong></span><span style="color: rgb(26, 99, 255); font-size: 20px; font-family: Tahoma;"><strong><span style="color: rgb(26, 99, 255);"><br></span></strong></span></td>
                  </tr>
<tr>
                    <td width="20%" height="15" style="text-align: left; font-family: Arial; font-size: 10px;"><span style="font-size: 16px;"><label for="value54"><label for="value54"><input type="radio" name="radAmount" id="value54" onclick="this.form.donationamount.value=this.value;" value="54.00"> <span class="introtext">$54.00</span></label></label></span></td>
                    <td width="20%" height="15" style="text-align: left; font-family: Arial; font-size: 10px;"><span style="font-size: 16px;"><label for="value72"><label for="value72"><input type="radio" id="value72" onclick="this.form.donationamount.value=this.value;" name="radAmount" value="72.00"> <span class="introtext">$72.00</span></label></label></span></td>
                    <td width="20%" height="15" style="text-align: left; font-family: Arial; font-size: 10px;"><span style="font-size: 16px;"><label for="value118"><label for="value118"><input type="radio" name="radAmount" id="value54" onclick="this.form.donationamount.value=this.value;" value="118.00"> <span class="introtext">$118.00</span></label></label></span></td>
                    <td width="20%" height="15" style="font-family: Arial; font-size: 10px;"><span style="font-size: 16px;"><label for="value180"><label for="value180"><input type="radio" id="value180" onclick="this.form.donationamount.value=this.value;" name="radAmount" value="180.00"> <span class="introtext">$180.00</span></label></label></span> <label for="value180"><label for="value180"><span class="introtext"><br></span></label></label></td>
                  </tr>
<tr>
                    <td width="15%" height="15" style="text-align: left; font-family: Arial;"><span style="font-size: 16px;"><label for="value360"><label for="value360"><input type="radio" id="value250" onclick="this.form.donationamount.value=this.value;" name="radAmount" value="360.00<"> <span class="introtext">$360.00</span></label></label></span></td>
                    <td width="15%" height="15" style="text-align: left; font-family: Arial; font-size: 10px;"><span style="font-size: 16px;"><label for="value540"><label for="value540"><input type="radio" id="value540" onclick="this.form.donationamount.value=this.value;" name="radAmount" value="540.00"> <span class="introtext">$540.00</span></label></label></span></td>
                    <td width="20%" height="15" style="font-family: Arial; font-size: 10px;" colspan="2"><span style="font-size: 16px;"><label for="valueOther"><input type="radio" value="0.00" onclick="this.form.donationamount.value=this.value;" name="radAmount" id="valueOther"> <span class="introtext">Other</span></label> <span class="introtext" id="OtherValue">$ <input type="text" value="0.00" id="donationamount" name="donationamount" size="7" class="Form_Text_box"></span></span></td>
                  </tr>
                </tbody>
              </table>
<table width="663" cellspacing="0" cellpadding="0" border="0" align="center" style="" dir="ltr">
                <tbody>
                  <tr>
                    <td bgcolor="#D8B876" style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="5"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style4 style2 style1 style68"><strong>Billing info</strong></span></td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Card Type</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><select tabindex="22" size="1" name="x_card_type"><option selected value="Please Select">Please Select</option>
                          <option value="Visa">Visa</option>
                          <option value="Mastercard">Mastercard</option>
                          <option value="American Express">American Express</option>
                          <option value="Discover">Discover</option></select></span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14); font-size: 12px;" class="style6">CC Number</span> <span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 172px; height: 22px;" name="x_card_num" required="false" size="16" tabindex="26">
<br></span></td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Donation Amount</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 165px; height: 22px;" name="Donation amount $" required="false" size="21" tabindex="24"></span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6">EXP MM/YYYY<select style="width: 87px;" name="x_exp_month" tabindex="27"><option selected value="Month">Month</option>
                          <option value="01">01</option>
                          <option value="02">02</option>
                          <option value="03">03</option>
                          <option value="04">04</option>
                          <option value="05">05</option>
                          <option value="06">06</option>
                          <option value="07">07</option>
                          <option value="08">08</option>
                          <option value="09">09</option>
                          <option value="10">10</option>
                          <option value="11">11</option>
                          <option value="12">12</option></select>  <select tabindex="28" size="1" name="x_exp_year"><option selected value="Year">Year</option>
                          <option value="2014">2014</option>
                          <option value="2015">2015</option>
                          <option value="2016">2016</option>
                          <option value="2017">2017</option>
                          <option value="2018">2018</option>
                          <option value="2019">2019</option>
                          <option value="2020">2020</option>
                          <option value="2021">2021</option>
                          <option value="2022">2022</option></select> </span></td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Total Charge</span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"><input type="text" style="width: 167px; height: 22px;" id="x_amount" name="x_amount" required="false" size="21" tabindex="25"></span></td>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);"><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6">CVV <input type="text" style="width: 173px; height: 22px;" name="x_card_code" required="false" size="22" tabindex="29">  </span></td>
                  </tr>
<tr>
                    <td style="font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; border: 1px dotted rgb(211, 211, 211);" colspan="5">
                      <p><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style6"> </span><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style3 style1 style2 style4">Comments</span><span style="font-family: tahoma; color: rgb(103, 54, 14);" class="style5"><br>
   <textarea style="width: 595px; height: 39px;" name="comments" required="false" cols="64" tabindex="30"></textarea></span></p>
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<p> </p>
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<script>



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