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JWC Sign-up/ RSVP Form:

Personal Information  
First Name
Last Name
Address
City, State, Zip
Phone
Email
  Please add my email address to the weekly email list
Please add my email address to the JWC email list
How many attending?
Comments/Feedback?

Help sponsor the evening!

$18.00 Suggested Donation
Co-Sponsor - $54.00
Other

Payment Information  
Amount
Name on Card
Credit Card Number
Security Code What's this?
Expiration Date
I'd like to pay by check. Please make your check payable to Chabad of Frederick.