Full Name* First Name Last Name E-mail* Adult Attendees:* Children Attendees: Names of Attendees: Optional Donation $54 - Grape Juice Sponsor $100 - Challah Sponsor $180 - Matzah Ball Soup Sponsor $360 - Dinner Sponsor Other Donation Donation Amount: $ Total $0.00 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 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 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: Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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