30th Registration and Ad Form

Couvert $100/person | $180/couple | $1500 Reserved VIP seating for 10 guests

Attendance*

YES! I will attend the Chabad House on Campus 30th Anniversary Celebration! I would like Unfortunately, I am unable to attend.

If yes, please enter the number of attendees:

Total Attendance

$ USD

Choose a Section/Sections Provide a message for each ad below

Honoree - Rabbi Leon Morris Myer and Ann Cohen Service Award - Mrs. Toni Marcovitz-Linzer Chabad House 30th Anniversary Memorials

Choose a Category/Categories

$5000 Platinum Sponsor $3600 Diamond Sponsor $1800 Sapphire Spsonsor $1000 Gold Sponsor $500 Silver Sponsor $360 Bronze Sponsor $180 Friend Sponsor $100 Sponsor

Message for each ad selected Please indicate the section and category associated with each message

Total Ads

$ USD

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Yes, I would also like to make a contribution to Chabad House on Campus in honor of its 30th Anniversary of serving college students in the Pittsburgh area!

Contribution

$ USD

Note for contribution

Full Name*

First Name Last Name

E-mail*

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Total Payment

$0.00 USD

Payment*

Credit Card Paypal

Postal / Zip Code

Country

Dinner Reservations

Ads and Contributions

Billing Information