CHS Payment Form - chabadwestside.org

PLEASE NOTE: This form is for payments for Chabad Hebrew School
and Supper and Study only.
To make a tax deductible contribution, please click here.
Full Name*
First Name Last Name
E-mail*
Phone Number*

Area Code Phone Number

Address*

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

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