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REGISTRATION FORM
Fees: $20 /Person |Sponsor- $180
Personal Information
First Name
Last Name
Address
City
State
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Home Phone
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Keep me updated with future Jewish events in the community
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RSVP Information
How Many Attending?
$20/person


I would like to be a sponsor of this event for $180 ~ Includes a private dinner with the speaker.

PAYMENT
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Full amount to be charged
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