Purim in the Airport Purim Reservations
First Name
Last Name
Address
City
 
State
Zip
Phone
Email
     
Purim Party    
adults ($18)   children ($12)
     
Optional Sponsorship
Amount $ (Sponsors of $250 or more will be recognized at the event)
 
Payment
I will mail my check to Chabad at Chestnut Hill
Please charge my Credit Card
Card Number   Total Charge Amt.
Expiration   CVV Code