Mitzvah-Corps-Dinner.jpg 

 

Online Reservations:

Last Name

How Many Reservations?
(Not including volunteers)

 

First Name

How Many Volunteers?

Address

Charge Amount for Reservations

City/State/Zip

CC Type

Phone

Card Number

E-mail

Exp. Date

 

Please Make Reservations For:
(please check box after name(s) of attendees requiring a children's menu)

Name of Attendee:
 
Kid's Menu:  | Vegitarian Menu:

Name of Attendee:  
Kid's Menu:  |  Vegitarian Menu:

Name of Attendee:
 
Kid's Menu:  | Vegitarian Menu:

Name of Attendee:  
Kid's Menu: | Vegitarian Menu:

Name of Attendee:
 
Kid's Menu:  | Vegitarian Menu:

Name of Attendee:  
Kid's Menu: | Vegitarian Menu:

Support the Program (optional):

Yes!  I/We would like to show my/our support in the Mitzvah Corps Tribute Book:

 

$180 - Full Page Ad

 

$100 - Half Page Ad

 

$50 - Quarter Page Ad

 

$25 - Greeting:  
(please type greeting above- 15 words or less)

 Please create my ad for me using the following text:

 I will e-mail you a ready made ad to use by May 3rd.
(Please send ads to [email protected] in .doc, .psd, .jpeg files only) 

Please confirm the total to be charged to your credit card for your contribution:  

If this donation is in honor/memory of someone, please fill in the name and address to which you would like a notification card mailed along with a message to the recipient:

 


Problems with this form?  Please call (414) 228-8000  or e-mail us here

We look forward to seeing you there!