1. Family Info Full Name* First Name Last Name Spouse Name First Name Last Name Address Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Phone Number* Area Code Phone Number E-mail* 2. Rosh Hashanah & Yom Kippur Services Seat Reservations at Chabad of Studio City$300 Adult I $100 Children Men Women Boys - Under Bar Mitzvah Girls - Under Bat Mitzvah Comments? 3. Honors and Blessings Honors and Blessings Rabbi, please call me to discuss the possiblity of our family receiving an Exclusive Honor and Blessing at the Torah, during the High Holiday service. 4. Rosh Hashana dinners at the Baitelman Home | 8:00 pm$75 Adults | $25 Children Adults, Rosh Hashana Night 1. Monday Eve, Sept. 22 Children, Rosh Hashana Night 1. Monday Eve, Sept. 22 Adults, Rosh Hashana Night 2. Tuesday Eve, Sept. 23 Children, Rosh Hashana Night 2. Tuesday Eve, Sept. 23 5. Family Dinner in the Sukkah at Chabad | 6:00 pm$75 Adults | $25 Children Adults, Sukkot Night 1. Mon Eve, Oct 6 Children, Sukkot Night 1. Mon Eve, Oct 6 6. Grand Simchat Torah Family Celebration at Chabad l 6:00 PMRSVP Required / Free of Charge Adults, Tuesday Eve, Oct. 14 Children, Tuesday Eve, Oct. 14 7. I would like to make an additional contribution to Chabad Donation amount $180$360$540$900$1000$1800$3600 8. I would like to sponsor a Seat/Holiday Dinner for someone in need Sponsor a Seat: $300 Sponsor a Dinner: $75 9. Payment Total payment $0.00 Payment Method* Credit Card Other Payment Options Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2025202620272028202920302031203220332034 Expiration YearFor Check:Please mail check to Chabad of Studio City 3816 Laurel Canyon Studio City CA 91604For Zelle: Zelle Payment [email protected] Nobody will ever be turned down at Chabad due to lack of funds. If you need assistance please contact Rabbi Baitelman. 818-508-6633 [email protected] Submit Should be Empty: This page uses TLS encryption to keep your data secure.