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Torah Studies RSVP

Torah Studies RSVP

JLI

July 15 - September 24, 2015 

Wednesdays @ 8:00 PM

 

REGISTER 

Number of Persons: 

Names of People Attending:  

$45 per person

$75 per couple

Text Book Included

PAYMENT AMOUNT:  

  

PERSONAL INFORMATION

First Name: *

  Last Name: *

  

Address:

City: *

  Zip Code *

 

 

Phone Number:

 

 

  Cell Phone:

 

 Email: *

PAYMENT INFORMATION

 Card Type: *

 

Card Number: *

  Sec Code: *

  

 

Exp Month: *

 Exp Year: *

 

  

 

 

 

 

  Please mail a receipt to the address above (in addition to the receipt I will receive via email).

 

Comments (optional)

 

 

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