Full Name* First Name Last Name E-mail* Phone Number Area Code Phone Number Number of Attendees:* 1 2 3 4 5 6 Names of Attendees: I would like to contribute towards Kiddush Lunch! Sponsorship Please consider sponsoring or co-sponsor the Shabbat Kiddush $180 $100 $50 Payment Credit Card Paypal Check/Cash Credit Card Visa MasterCard American Express Discover Credit Card Type Credit Card Number Security Code Name on Card 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Expiration Month 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 Expiration Year Paypal has been selected. Payment will take place on the next page. Please mail check to: Chabad of Chula Vista 1910 Harrils Mill Ave Chula Vista, CA 91913 Comments/Feedback Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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