Thursday Night, May 21 Shavuot Dinner 6pm & Tikkun Leil Program 8pm Full Name* First Name Last Name E-mail* Phone Number* Area Code Phone Number I am attending the following Shavuot DinnerTikkun Leil ProgramBoth Are you booking for others? YESNO Number of attendees Name of Attendee They are attending the following Shavuot DinnerTikkun Leil ProgramBoth Name of Attendee They are attending the following Shavuot DinnerTikkun Leil ProgramBoth Name of Attendee They are attending the following Shavuot DinnerTikkun Leil ProgramBoth Name of Attendee They are attending the following Shavuot DinnerTikkun Leil ProgramBoth Name of Attendee They are attending the following Shavuot DinnerTikkun Leil ProgramBoth Let us know if there is another family you'd like to sit with Do you or any of the attendees require support? YesNo If yes, please let us know what additional support you need Number of Adults at $65 ea Number of Children between 6-12 at $45 ea Number of Children between 3-5 at $30 ea Chldren under 3 free Optional donation $50 AUD$75 AUD$100 AUD$180 AUD Total $0.00 AUD Yes, I'd like to make this a monthly recurring payment. Payment* Credit Card We accept Visa, MasterCard, American Express Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration Year Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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