Please join us to honor Michele Heller at Shabbat a la Mode, Friday May 3rd at *6:15 pm - Featuring Mike and the Mensches and our Children's Choir *(Please note the new time of 6:15 PM)
Email address *
Number of Adults *
Family Last Name (s) of Adults *
Your answer
First Name (s) of Adults *
Your answer
Number of Children *
First name (s) of Children (if applicable)
Your answer
How many Adult guests (non- member) (at $18 each)? *
First and Last name of adult guest (s)
Your answer
How many child under-12 guests (non- member) (at $15 each)? *
First and Last name of children guest(s)
Your answer
Other information you would like to share?
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service