Printed from JewishSC.com

Purim in Persia

Purim in Persia

 

Purim in Persia Registration Form

First Name

 

E-Mail

Last Name

 

Phone

Number of People   Names of Attendees

 

       
Admission
$10 per Person  $50 max per family      
Sponsorship $180 or $360      
         
Payment
CC Type   Card Number
Billing Address   City, State, Zip   
Charge Amount   Exp Date   
CVV

 

 

 

Secure This page uses 128 bit SSL encryption to keep your data secure.