REGISTRATION FORM FOR
THE ANNUAL CAMPAIGN FUNDRAISING SEMINAR
WITH RABBI BROD
Wednesday, November 13th, 2025 / 22 Cheshvan, 5786
10:00 AM to 6:00 PM.
The Shluchim Office, 816 Eastern Parkway
| First Name | |
| Last Name | |
| Mosed | |
| City | |
| State | |
| Country | |
| Cell | |
|
Payment Info Card type: Name as on Card: Credit card number: Expiration: CardID (CVV):? Card Billing Address: City: Zipcode: State: Country: | |