B"H

High Holidays
Lulav & Etrog set order form

  Your Information:
Name
Address
City, State
Zip
Daytime Phone
Email


Lulav & Etrog sets:
Please reserve for me Lulav & Etrog set(s) @$55

Additional High Holidays Donations:
In support of the work of Chabad, I would like to make an additional High Holiday donation of $

  Payment Information
Method of Payment  use credit card on file
 credit card 
PayPal
 bring a check when I pick up my set

paypal.jpg

 If you choose the PayPal option, click on the PayPal link to submit your payment.  Then be sure to come back and click "Submit" on this form, so that we receive your order. 

Credit Card #
Exp. Date (MM/YY)
Security Code
Total amount of payment