Contact Information
Title
- Select title -
Mr.
Mrs.
Ms.
Dr.
Mr. & Mrs.
Dr. & Mrs.
Rabbi
Rabbi & Mrs.
First Name
Last Name
Address
City
State
Zip
Email
Bar / Bat Mitzvah fee:
Type
Number
Amount
Total
Fee
$
1800
$
0.00
Discount Fee CHS 1
$
1400
$
0.00
Discount fee CHS 2
$
1200
$
0.00
Installment
$
300
$
0.00
Total
0
$
0.00
Other Amount
Total Amount
$
0.00
Payment Method
Credit Card
E-Transfer: Rabbi@Chabaddb.com
Credit Card Information
Type
Visa
MC
Amex
Number
Expiration
- Choose month -
1 - January
2 - February
3 - March
4 - April
5 - May
6 - June
7 - July
8 - August
9 - September
10 - October
11 - November
12 - December
- Choose year -
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
Code
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