Bat Mitzvah Gala Dinner

Sunday, May 23rd, 2010,  5:30pm

(Scroll down for the form) 

$36 Adults   $25 per child (12 & under) 

Reservations must be by Sunday May 16th! 

  First Name(s)  

Last Name

Address  City

Phone  Email

Number of People in party:    1 2 3 4 5 6 7 8 9 10 Adult/s    1 2 3 4 5 6 7 8 9 10 0  Children

If you are not putting in a credit card please just email me all the reservations!

   I would also like to be a co-sponsor for the gala dinner for $360!

Card Type Visa Master Card Amex Card Number

Expires    CVV code     Amount  

Billing Address

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