High Holiday Reservation Form 5782



Full Name:


City: State: Zip:

Home Number:  Cell Number: 




Services which I/we will be attending: (Required)

Rosh Hashana - Sept. 6 - 8   Yom Kippur - Sept. 15 - 16

Anyone joining for services will also be assessed a security fee.

Please indicate where you would like to be seated for the high holiday services below: (Required) 

 Main Sanctuary - Chabad davening in Ashkenazic tunes with Rabbi Mordechai Shain
 Social Hall (Kiddush Room) - Chabad Davening in Sephardic tunes with Rabbi Yitzchak Gershovitz

Please select (required):

  $1,800 Family (4 people) + $360 Security Fee - Total $2,160

 $1,080 Couple (2 people) + $360 Security Fee - Total $1,440

 $770 Single (1 person) + $180 Security Fee - Total $950

 $360 Add'l Family Member/Guest (Not a spouse)

Please indicate the number of Men and Women seats below:

Men Women




  I am not attending but would like to make a high holiday donation.

Payment Method


Please charge my credit card

Card number: Exp date (mm/yyyy):

Cardholder Name:

Address of Cardholder:

State of Cardholder:   Zip of Cardholder: 

CVV Security Code What's This?

Amount to be charged to credit card:


Wishing you a happy and healthy sweet new year!