Non-Members Reservation Form

NON-MEMBERS’ RESERVATION FORM HIGH HOLY DAYS SERVICES, 5777 (2016)

We hope to see you for High Holy Days services this year! Please carefully review this form, complete all items below and return the form by Friday, September 23, 2016 with payment in full. Please mail all forms to Congregation Beit Tikvah, 5802 Roland Avenue, Baltimore, MD 21210-1310. For general information, kindly contact our office (410-464-9402, [email protected]) and for payment questions or arrangements, kindly contact our treasurer (410-464-9402 option 3, or email [email protected]).

 Contact information Name______Address ______

City, State and Zip-Code Telephone Number

E-mail Address

 Suggested minimum donations for High Holy Days services 1st Adult, $180; 2nd Adult in the family, College Students, or Seniors (over 65) $100

Please indicate the number of people attending each service. ___ Erev Rosh Hashanah ___ 1st Day Rosh Hashanah ___ 2nd Day Rosh Hashanah

___ Kol Nidre ___ Yom Kippur Day  Names of all adults and children who will be in your group (include ages for children - age 12 & under) ______$ ______$ ______$ ______$ ______$ ______$ ______Total  $ ______

 Additional reservations/donations I/We will attend Break-Fast: (# attending _____ x $12 per adult) + (____ x $6 per child under 12) $______I/We wish to make an additional tax-deductible donation:  $36  $54  $72  $100  other ______$ ______I/We wish to dedicate a prayer book ($54) for the synagogue (write dedication wording on separate sheet) $ ______Yizkor Book Payment (see attached form) $ ______

Total amount of section ➌ and ➍  $ ______

 I/We wish to receive membership information. Please consider joining Beit Tikvah!

 Payment Options To eliminate money handling during High Holy Days, donations are to be paid in full and in advance by Friday, September 23, 2016.

 My total amount due, $ ______in ➍ above, is paid by check (enclosed).  My total amount due, $ ______in ➍ above, is to be charged to my credit card as follows:

Name on credit card, card number, expiration date, street number only and 5-digit zip code of address to which your credit card bill is routinely mailed (required) only Discover, MasterCard or Visa accepted:

Name on card ______Number ______Exp. Date ______

Street # ______Zip ______Security number on back of card (3 digits) ______Signature