RJC's 65th Annual Dinner 2019 - Form - Riverdale Jewish Center

* First Name

* Last Name

* Email

* Phone

* Please select the appropriate box below:

Please Select OneI would like to make a reservation and place a scroll of honor listingI can not attend but would like to place a scroll of honor messageI am an AMUD member and would like to make a reservation and add a message in the scroll of honorI would like to only make a dinner reservation.

* Please indicate the number of reservations below (choose "0" if you are only purchasing a scroll listing).

The RJC will be preparing a digital scroll of honor that will be on display on the evening of the Dinner, as well as on our website following the dinner. Please review the sponsorship options below. Please note that, as indicated, many of the selections include complimentary tickets. More details can be found below.

Please type your message here (please note that this is not an ad, but rather a message of tribute to the honorees). All messages will appear on the page corresponding to the donation level.

I would like to make an additional donation at this time (enter amount below):

Select the Appropriate Box:

Please Select OneGeneral Admission - $250 per seatYoung Professionals - $125 per seat

General Admission - $250 per seat

If you are not placing a scroll listing, please use the dropdown menu above to select how many general admission tickets you would like to purchase.

Young Professionals Admission - $125 per seat

If you are not placing a scroll listing, please use the dropdown menu above to select how many Young Couple admission tickets you would like to purchase.

Please indicate the names of attendees:

*Optional Nachas Pages - I would like to list ___ amount of children/grandchildren on the Nachas Pages

If you are interested in listing children and/or grandchildren in the Nachas Pages, please note how many names you would like to list in the box above - for each name, there is a required $18 contribution toward the dinner campaign. If participating, please note all names in the Comment Box that follows.

*Optional: Please include me on the following special Hakarat HaTov Scroll of Honor Page:

Hakarat Hatov

Nachas Grandchildren Names:

If you are participating in the Nachas Pages, please list the names of your children/grandchildren in the box above. Thank you!

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