Congregation Emanu-El of the City of New York

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RECEIPT

Shabbat Kodesh Family Worship Service and Dinner

Friday, May 18, 2018 — Please note our special start time and location!
Service: 6 PM (Fifth Avenue Sanctuary) | Dinner: 7 PM (I.M. Wise Hall)

Our final family service of the year, in the majestic Fifth Avenue Sanctuary, will feature joyful music led by Cantor Mo Glazman, Hadar Orshalimy and a three-piece band. At this service, we will celebrate our students who have earned Religious School With Honors and our Seventh Grade Mitzvah Messengers. The service will be followed by a special family dinner including a dessert reception for Religious School With Honors recipients.

Payments for dinner must be received before the event. The basic charge for dinner is $55 per family (up to two adults and any number of children) for reservations made by May 14, 2018; $75 after May 14. Teens (8th-12th graders), if unaccompanied by an adult: $15 each. Additional adults: $20 each. After May 14, cancellations cannot be refunded.

DINNER RESERVATION

Qty

Description

Amount

Total

Family Reservation

$75.00

---

(up to two adults and any number of children)

Teens (8th-12th graders)

$15.00

---

(unaccompanied by an adult)

Additional Adult(s)

$20.00

---

Total: $0.00

Family Information

Are you Temple members? *

Family Last Name: *

First Name (Adult 1):

First Name (Adult 2):

Please include the last name if it differs from Adult 1.

Please indicate the name of each child attending and his or her current school grade.

Name/Grade of Child #1:

Include the first and last name of each additional adult who will be attending dinner.

Additional Adult #1:

Questions/Comments:

Please let us know if you have any questions or concerns.

Contact Information

Person Completing Form: *

Preferred Email Address: *

Preferred Phone Number: *

Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

Email: *

A receipt will be emailed to this address.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *