CiviCRM - ALEPH: Alliance For Jewish Renewal

SHALOM! READ ME FIRST!

Welcome to the registration for Honoring the Life and Legacy of Reb Zalman.

This event will take place on Sunday, July 14 at 4pm ET (1pm PT.)

To complete your registration, please make sure you click on the "Continue" button at the end of this form.

NOTE: Registrants to this program will have their email addresses shared with the leader who may share materials relevant to the session.

By completing this registration, you agree to the ALEPH: Alliance for Jewish Renewal Event Registration Terms and Conditions, which can be found at www.aleph.org/eventregistrationtermsandconditions.

If you have questions, please email tikshoret@aleph.org.

Thank you!

REGISTRATION FORM

How many people are you registering? *

Registrant Information

Formal Title

First Name *

Last Name *

Street Address (Home) *

City (Home) *

Postal Code (Home) *

Country (Home) *

State (Home)

Province (non US)

Email (Primary) *

Preferred/best phone *

Donation *

Donation in Reb Zalman's Honor - $ 5.00

Donation in Reb Zalman's Honor - $ 10.00

Donation in Reb Zalman's Honor - $ 18.00

Donation in Reb Zalman's Honor - $ 25.00

Donation in Reb Zalman's Honor - $ 36.00

Donation in Reb Zalman's Honor - $ 72.00

Donation in Reb Zalman's Honor - $ 100.00

Donation in Reb Zalman's Honor - $ 180.00

Donation in Reb Zalman's Honor - $ 250.00

Total for this participant

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *