Simchat Torah Participant

 Please note that names will appear on printed Sinchat Torah booklet only donations of $180,  however, any and all donations are welcome to help defray the costs of food and cleaning, which are estimated at $3500

Please accept my donation in the amount of

Sponsoring which Hakafah:  

In memory of        In honor of: 

Please list names:  

Personal Information:

First Name:    Last Name:

Address:     City:

State:     Zip:    Cell Phone:

Credit Card Information:

Name on Card:

Credit Card Number:

Expiration Date:

By submitting this form, you are authorizing Chabad of Coral Springs to run your credit card for the amount specified above.