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CONGREGATION ETZ CHAIM ~ HIGH HOLY DAYS 5771
Tickets & Reservations for Services, Selichot, Rosh Hashanah luncheon, & Break the Fast
A. Member’s Family / Out of Town Guest Tickets (please be sure to write names on back of form):
____ Number of Tickets @ $50 Sub Total $___________
B. Non-Member Tickets (please be sure to write names and selections on back of form):
____ Number all services @ $100 ____ Number single services @ $50 Sub Total $___________
C. Yizkor Book of Remembrance (please be sure to write names on the back, form due September 13th):
___ $18 1 st name ___ $18 2nd name ___ Names @ $10 each $_____ Sub Total $___________
I wish to make my High Holiday Appeal donation at this time:
__ $100 __ $180 __ $360 __ $500 __ $1000 __ $1000 __ $1800 __ $5000 __ Other $_________
Sub Total $___________
I plan on attending the following High Holidays functions. My guests are listed on the back of this form:
Selichot: Saturday, Sept. 4, 7:30pm. For reservations please contact Gloria at 954-578-9454 or djf007@gmail.com
____ Bring a dairy dish for 8-12 OR ____ $18 per person Sub Total $___________
Rosh Hashanah Luncheon: Thursday, Sept. 9, 1:30pm. Reserve by Sept. 1. RSVP to mkltub@aol.com
____ Number of Reservations @ $30 each Sub Total $___________
Break-the-Fast: Saturday, Sept. 18, 7:30pm. Reserve by Sept. 13 to Gloria at 954-578-9454 or djf007@gmail.com
____ Number of Reservations @ $30 each Sub Total $___________
Method of Payment
__ Check or Money Order __ Visa __ MasterCard Amount Charged/Paid $_____________
(Make payable to: Congregation Etz Chaim)
Credit Card Nbr: ___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___ ___ Three Digit Security Code: ___ ___ ___
(From back of card)
Name as it appears on card/check: ________________________________________________ Phone: ______________________
Expiration Date: _________/________ _________________________________________________________
Month Year SIGNATURE (Required for Credit Card Payment)
Billing Address: _____________________________________________________________________________________________
Return completed form to: Congregation Etz Chaim, 1881 NE 26th Street, Suite 100, Wilton Manors, FL 33305
Thank You and Shana Tova!
CONGREGATION ETZ CHAIM ~ HIGH HOLY DAYS 5771
Tickets & Reservations: Names
A. Member’s Family / Out of Town Guest Tickets
Name: __________________________________________________Relationship: _____________________________
Name: __________________________________________________Relationship: _____________________________
Name: __________________________________________________Relationship: _____________________________
Name: __________________________________________________Relationship: _____________________________
B. Non-Member Tickets
All Services Single Service **Day of Single Service
Name: ____________________________________ __________ _____________ ______________________
Name: ____________________________________ __________ _____________ ______________________
Name: ____________________________________ __________ _____________ ______________________
Name: ____________________________________ __________ _____________ ______________________
** Day of Single Service: Erev Rosh Hashanah, Rosh Hashanah, Kol Nidre, Yom Kippur
C. Yizkor Book of Remembrance : In Memory of...
_______________________________________ _______________________________________
_______________________________________ _______________________________________
_______________________________________ _______________________________________
_______________________________________ _______________________________________
_______________________________________ _______________________________________
Selichot attendees:
Name: ____________________________________ Name: ____________________________________
Name: ____________________________________ Name: ____________________________________
Rosh Hashanah Luncheon attendees:
Name: ____________________________________ Name: ____________________________________
Name: ____________________________________ Name: ____________________________________
Break-the-Fast attendees:
Name: ____________________________________ Name: ____________________________________
Name: ____________________________________ Name: ____________________________________
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