Seat Reservations members

Full Name*

First Name Last Name

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number*

Area Code Phone Number

E-mail*

Current Membership Plan

Single - $1000 (Includes 1 High Holiday seat for adult)Family - $2000 (2 High Holiday seats for adults)Honorary - $3600 (Includes plaque in our lobby with your name, 4 High Holiday seats for adults)Gold - $5000 (Includes plaque in our lobby with your name, 4 High Holiday seats for adults)Pillar - $10,000 (Includes plaque in our lobby with your name, 4 High Holiday seats for adults)Founder - $18,000 (Includes plaque in our lobby with your name, 4 High Holiday seats for adults)Builders - $26,000 (Includes plaque in our lobby with your name, 4 High Holiday seats for adults)

Please reserve the following HH seats

Please indicate when seats are needed:*

Rosh HashanaYom Kippur

# of men's seats

# of women's seats

Purchase extra seats not inclusive of membership $75 per seat

# of men's seats

# of women's seats

Names of attendees

Any comments / seating preferences

How many children will be joining:* Ages 4 - 12

Which days will your child(ren) be attending:

Sept 23rd: Rosh Hashana day 1Sept 24th: Rosh Hashana day 2Oct 1st: Yom Kippur EveOct 2nd: Yom Kippur Day

Child #1: Name*

Child #1: Age*

Child #2: Name*

Child #2: Age*

Child #3: Name*

Child #3: Age*

Child #4: Name*

Child #4: Age*

How many children will be joining:* Ages 18 months - 3 years

Child #1: Name*

Child #1: Age*

Which days will Child #1 be attending:*

Sept 23rd: Rosh Hashana day 1Sept 24th: Rosh Hashana day 2Oct 1st: Yom Kippur EveOct 2nd: Yom Kippur Day

Child #2: Name*

Child #2: Age*

Which days will Child #2 be attending:*

Sept 23rd: Rosh Hashana day 1Sept 24th: Rosh Hashana day 2Oct 1st: Yom Kippur EveOct 2nd: Yom Kippur Day

Total

$0.00

Payment

Credit Card

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Name on Card
Expiration Month	Expiration Year

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Holiday Date

Seat Reservations for members

Your Information

High Holiday Seat Reservation

Children's Program

Babysitting Group

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