Calendar Dedication Page

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Total Amount

Profile

First Name

Last Name

Street Address

City

State

Postal Code

Phone

Details of your dedication* Please put commas between each dedication. (e.g. Stan Brooks birthday 5 June 2002, Molly Lewis Yahrzeit June 9, 2021 before sunset, (Sivan 29, 5781).

Please put commas between each dedication. (e.g. Stan Brooks birthday 5 June 2002, Molly Lewis Yahrzeit June 9, 2021 before sunset, (Sivan 29, 5781).

Authorize.net (Credit Card)

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Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

CHABAD OF STAMFORD - JEWISH CENTER FOR LIFE AND LEARNING