Please Note: Due to space limitations, we require pre-applications for the Pesach Seder. Please fill out the entire form. Upon receipt of your submission, we will let you know via email if we are able to accommodate your reservation request. Your card will not be charged until reservation is confirmed Reservations are not confirmed until you receive a confirmation email or phone call . Thanks for your understanding. Full Name* First Name Last Name E-mail* Phone Number* Area Code Phone Number Adults Suggested donation 18-72/person Children Suggested donation 18-72/person I want to sponsor $3600 USD$1800 USD$770 USD$250 USD$72 USD$36 USD$18 USD Total Charge $0.00 USD Payment Method Credit Card Paypal Other Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Expiration Month 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 Expiration Year Paypal has been selected. Payment will take place on the next page. Mail Check payable to Pardess Center for Jewish Life 171 Blue Hill Rd Hopewell Jct NY 12533 Comments? Questions? Submit Should be Empty: This page uses TLS encryption to keep your data secure.