Purim-Israel 

Yes, I will be attending Israeli Purim!
Title:   State:
First Name:   Zip:
Last Name:   Phone:
Address:   Email:
City:      
# of Adults:   # of Children:
Adults: $15 in advance, $20 at the door, $50 for an entire family.   Children: $10 in advance, $12 at the door.
Payment:
I would like to sponsor this event for $540, $1,800 or $3,600 Please specify below.
  In honor of: or In memory of:
 
 
Please charge my card in the amount of: $ .00  
Card Type  
Check or Card No.   CVV Code
Card Exp:    

Comments:

We look forward to celebrating this FESTIVE HOLIDAY with you!