Registration Form

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FRIDAY NIGHT DINNER & LECTURE
The Struggle for Jewish Identity
on College Campuses
Friday Evening, May 23, 2008
Mincha at 6:45 pm
Dinner at 7:45 pm
$36 per person

Form

*Denotes required field

*Last Name               

*First Name               

*Title                       

*Phone Number         

 Email                       

 Address                   

 City                       

 Postal Code             

We will be attending:

 Friday night Dinner & Lecture
(Per Person $36)

 Shabbos day Kiddush (no fee)

No. of People

*Credit Card Type     

*Credit Card Number  

*Expiration Date      

*Name on Card        

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