This form is currently closed. Rosh Hashana Dinner 5787 Full Name* First Name Last Name E-mail* Phone Number* How many adults?* $35/adult How many children under 12?* $18/child Names of Attendees* Any Food Allergies? Payment* Credit Card Paypal 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 Month2026202720282029203020312032203320342035 Expiration YearPaypal has been selected. Payment will take place on the next page. Total $0.00 USD I would like to receive news and updates by email Should be Empty: This page uses TLS encryption to keep your data secure.