Rosh Hashanah Children's Services Parent/Guardian Name(Required) First Last Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Email(Required) Location(Required)Please select which location, you will be attending. Chabad of Deerfield - 945 Sunset Ct. - Deerfield @ 10:30 am Central Avenue Synagogue - 874 Central Avenue, Highland Park @ 10:45 am Child InformationNumber of Children(Required)01234Child Name(Required) First Last Hebrew Name(Required) Date of Birth(Required) MM slash DD slash YYYY Child #2 InformationChild Name(Required) First Last Hebrew Name(Required) Date of Birth(Required) MM slash DD slash YYYY Child #3 InformationChild Name(Required) First Last Hebrew Name(Required) Date of Birth(Required) MM slash DD slash YYYY Child #4 InformationChild Name(Required) First Last Hebrew Name(Required) Date of Birth(Required) MM slash DD slash YYYY Donation AmountDonation not required, but appreciated!$0.00$18.00$36.00$54.00$72.00$180.00Donation Total We appreciate your generosity towards the future of the Dr. Sue Library!Credit CardCard Details Cardholder Name Questions? Contact michla@nschabad.org
