Printed from ChabadCentrepointe.com

Reservation Form

Reservation Form

online reg.jpg

 

Registration Form
 

* I WOULD LIKE TO JOIN CHABAD OF CENTREPOINTE FOR:

 

EVENT/HOLIDAY (DATE)

FIRST NAME:

LAST NAME:

MAILING ADDRESS WITH POSTAL CODE*:

EMAIL*:

TOTAL NO. OF PEOPLE:

NAMES OF ALL ATTENDEES:

PAYMENT METHOD, TOTAL OF $

Name:

Payment

Cheque (Mail to 23 Palisade St - Ottawa - ON- K2G 5M6)

Credit card (online) Card Type

Amount to charge $

Card Number

Expiration Date

Security Code

{Please contact us confidentially if you would like to attend for a discounted rate} 

 

 

WE LOOK FORWARD TO GREETING YOU!

Rabbi Chaim & Bassy Mendelsohn & the Chabad of Centrepointe Family

 

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