This form is currently closed. Full Name* First Name Last Name Please select the services you would like to attend: Rosh Hashanah Oct 2 (Wed) - Evening Services (6:30PM)Oct 2 (Wed)- Community Dinner (7:00PM)Oct 3 (Thurs) - Morning Service (10:00 AM followed by a Kiddush)Oct 3 (Thurs) - Children's Program (10:30 AM- 12:00 PM)Oct 3 (Thurs)- Shofar & Tashlich at the pond (6:00 PM)Oct 4 (Fri) - Morning Service (10:00 AM) Yom Kippur Oct 11 (Fri) - Kol Nidrei Evening Services (6:00 PM)Oct 12 (Sat) - Morning Service (10:00 AM)Oct 12 (Sat)- Afternoon Neila Service (4:45 PM)Oct 12 (Sat)- Break-fast (6:57) PM E-mail* Phone Number* Area Code Phone Number Amount Adult Attendees* 123456 Amount of Children Attendees 123456 List the names of the people coming, attending or any comments. We would love to see you and your family join us in welcoming the Jewish New Year! Please join us at our annual Rosh Hashanah Dinner at Chabad. Sit down meal includes specialty entrees, sweet foods, and of course apple and honey. Adults: $25 Children: $10 Adults 1 $252 $503 $75 Children 1 $102 $203 $30 Donations and Yizkor Book Yizkor Donation Amount* I don't have names for Yizkor BookNo Donation Per Name1 Name ($18)2 Names ($36)3 Names ($54)4 Names ($72)5 Names ($100)More than 5 Names ($100)Choose my Own Amount - see next section Please include all names as you want them in the yizkor book Chabad offers High Holiday services at no charge to the community. As always our services are without charge and participation is voluntary, but in light of the increased costs, we are encouraging and requesting your financial participation. Please consider the suggested donation of $100 per adult and $50 per child and young adult or consider being a High Holiday superstar with a High Holiday sponsorship. Would you like to make an additional donation? I would like to make a donation.Not at this time. Select a Choice $180 - Sponsorship$360 - Family Sponsorship$720 - Shana Tova Sponsorship$1,8000 - High Holiday Superstar SponsorshipEnter your own Superstar donation Enter your own amount* $ Total $0.00 Yes, I'd like to donate the cost of processing this transaction by adding 2.6% Payment Credit Card Check or Zelle Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2024202520262027202820292030203120322033 Expiration YearBilling Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Should be Empty: This page uses TLS encryption to keep your data secure.