Sholem Kol Nidre 2019 Name * First Last Last Email Phone Address Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Please consider a $200 SUPPORTER TICKET to help Sholem in 5780/2019-20. All donations are applied 100% to the Sholem school and related Sholem programs. $200. SUPPORTER tickets include $70 for admission and you will receive a tax receipt for a $130 donation. Supporter $200 ($70 ticket plus $130 donation) Select number of tickets $ Supporter Amount How you would like your name to appear in the printed program? (for example “Ben & Sarah Schwartz” or “The Schwartz Family.”) Member Adult, $70 Select number of tickets $ Member Adult Total Member Student/Senior, $65 Select number of tickets $ Member Student/Senior Total Non-Member Adult, $90 Select number of tickets $ Non-Member Adult total Non-Member Student/Senior, $80 Select number of tickets $ Non-Member Student/Senior Total Additional Contribution $ Any additional contribution will be accepted with gratitude, and a receipt will be emailed to you for tax purposes. [visibility-admin] In Memoriam, $18 per name Remember your loved ones of blessed memory by having their names appear in our printed program. Deadline Tuesday, October 1. Memoriam Names Please enter one name per line. Question or Comment about how you would like your loved one's name(s) to appear in the program Yizker No Cost The names of your loved ones who have died IN THE LAST YEAR will be read aloud at our Kol Nidre observance. Names can also be submitted at the door. Yizker Name The web form for Yisker is now closed. Please submit names at the door. plus1 Add minus1 Remove Childcare $15per child, $25 for two or more, reservations required. Number of Children Names and Ages Please enter the name and age of each child on a separate line Child Care Cost $15 for one child, $25 for two or more. Child Care Cost $15 for one child, $25 for two or more. Parent Information * Parent's name Parent mobile phone please include area code $200. SUPPORTER tickets include $70 for admission and you will receive a tax receipt for a $130 donation. Pay at Door Cash Check Credit Card Pay at the door fee additional $5 per ticket at the door Total $ Alternate Total $ Customer paid a different amount at the door Pay now
