
| First Name |
Last Name |
| Address |
City |
| State |
Zip Code |
| Phone |
Email |

| There is no charge for seats; your donation is greatly appreciated! Suggested donation: $54 individuals, $180 for a family. |
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| Amount Adult Attendees |
Amount of Children Attendees |
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| High Holiday Services I plan to attend
Please check all that apply. |
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| Rosh Hashanah Eve. | September 9 | ||
| Rosh Hashanah Day 1 | September 10 | ||
| Rosh Hashanah Day 2 | September 11 | ||
| Yom Kippur | September 18 - 19 | ||
| Day Service | ||

| Donations aren’t required, but there are hard economic realities which we can’t ignore. The only support we get is from... you. Consider a donation to help cover the costs of these and other wonderful programs that Lubavitch of Yardley brings to our community. | ||
| Other | ||
| Sponsor a Machzor - $30 each | *Kiddush sponsorships are additional to seat donations. | |
| Machzor dedicated in honor/memory of | ||
| Card Number |
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| Expiration |
CVV Code |
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| Total Amount to Charge Card |
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Checks can be mailed to Lubavitch of Yardley, 1444 Yardley Newtown Road, Yardley, PA 19067
100% of the proceeds of this donation or payment benefit Chabad Lubavitch of Yardley.
