PLEASE SPECIFY YOUR REQUEST
CHECK EITHER CHOICE  A OR  B

A)  ADDITIONAL INFORMATION

      PLEASE  ENTER YOUR INFO BELOW     

 B)  RSVP  ( RESERVATION )  
      PLEASE  ENTER YOUR INFO BELOW     

Please complete the form below to reserve a place at the event of your interest or to request further information.

Please be sure to click submit at bottom.

Family Name   First Name 

Phone numbers:  Day  Eve

Email  Seats Required 1 Seat 2 Seats 3 Seats 4 Seats 5 Seats 6 Seats 7 Seats 8 Seats

PROGRAM SELECTION Kollel Mitzion Shabbaton Bethesda Yeshiva Experience Friday Night @ Chabad, May 1       Adults 1 adult 2 adults 3 adults 4 adults 5 adults      Children 1 Child 2 Children 3 Children 4 Children 5 Children 6 Children  

YOU CAN PAY ANY PROGRAM FEE OR COVER CHARGE ONLINE AFTER YOU SUBMIT THIS RESERVATION FORM.   PLEASE SELECT THE PAYMENT BOX BELOW AND ENTER THE AMOUNT OF YOUR INTENDED PAYMENT.

► UPON SUBMITTING THIS RESERVATION FORM A CONFIRMATION PAGE WILL APPEAR AND DIRECT YOU TO THE ONLINE PAYMENT FORM. 

PAY NOW ONLINE    >>    AMOUNT OF INTENDED PAYMENT   

WILL PAY LATER      >>  AMOUNT OF PAYMENT Fri Night Adult $15 Fri Night Child $10 Fri Night Family $35 Sat Day Adult $10 Sat Day Child $5 Sat Day Family $25

NO PAYMENT NECESSARY 

Thank you for making plans to join our programs.

If you need to contact us, Please call 301 913-9777