Dinner Reservations Reservation Options Please choose one of the following: I would like to make reservation(s) for the Annual Dinner at $360 per couple I am making a donation of $500 or more, which entitles me to 2 dinner reservations Please fill in the names of those making reservations: Sorry, I cannot attend, but I am making a contribution of $ * Please note in the comment section below if this donation is to be made IN HONOR OF or IN MEMORY OF someone Contact Information Please fill in the details below. Fields marked with * are required Name* Address * City, State Zip* Contact No * Email * Payment Information Please indicate your method of payment Check Checks should be made to Monsey Beis Chaya Mushka and sent to: MBCM 27 South Monsey Road, Monsey NY 10952 PayPal (to pay via PayPal click the submt button first, then go to the PayPal link on the left.) Credit Card (please fill in the details below on our secure webform) Please charge my card the amount of $ Card # Ex Security Code Billing information (only if different from above) Name (as it appears on your card) Address City State Zip Phone ^Comments : This page uses 128 bit SSL encryption to keep your data secure.
