SIMCHAT TORAH DINNER RESERVATION FORM

2019 Simchat Torah Dinner Reservation Form

MakomNY Annual Simchat Torah Celebration

Join Our Community Simchat Torah Dinner and Celebration

October 20th, 2019 at 6:00pm
MakomNY at the Bethpage Worship Center

Students who are NEW to our MOADON School
will Receive a Special Honor and Blessing by Rabbi Bravo.

Dinner is followed directly by:

7:00pm - Simchat Torah Musical Service
7:30pm - Torah Unscrolling and Dancing
8:00pm - Festive Oneg Kiddush Celebration and Conclusion

All Are Welcome!

Make Your Dinner Reservations Now to Celebrate With Us
Parents, Bring Your Children to Receive Their Special Honor

Prior reservations are necessary for Dinner; Sign up using this form now.
Please RSVP no later than Thursday, October 17th.

Simchat Torah Dinner Fees
$22/adult attendee 13+; $16/Child or Moadon student 6 to 12;

No cost for New Students and children 5 and under

MakomNY at the Bethpage Worship Center, 600 Broadway, Bethpage

Contact Name *

First Name Last Name

Contact Email *

example@example.com

Select Number of Adult Attendees Age 13 yrs & older. ($22/attendee)

Please select from drop-down menu

Select Number of Children Attending between Age 6 and 12 yrs. ($16/child)

Please select from drop-down menu

Select Number of Children 5 years and younger OR new students to our Moadon (No Cost)

Please List the Names of ALL Attendees (Adults and Children) to Be Included on Your Reservation. *Please note the ages for all children

If you would like to make a Special Donation in Honor of your child/children at this Jewish milestone occasion, you may you may select an amount from the drop-down menu, or choose to make a custom donation below.

Please Enter Custom Donation

Please provide names of any child/children you are honoring with your Simchat Torah donation.

i.e. Sally Jones

Dinner Reservations (13 and older)	${dinnercostAttendees}
Dinner Reservation (ages 6-12)	${dinnercostChildren}
Special Contribution in Honor of Child	${specialdonationcost}
Total	${totalDonation}

Dinner-cost Attendees (11 and older)

Dinner-cost Children (10 and younger)

Special-donation-cost

Total Donation

Total Amount *

Total ( USD one-time payment.)

Payment Method

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country