Paint N' Sip

JWC Paint N' Sip

First Name *

Last Name *

Phone *

Email *

Street Address *

Postal Code *

Note

Event Fee(s) *

Registration for one - $ 25.00

Patron - Registration for one - $ 36.00

Registration for two - $ 50.00

Patron - Registration for two - $ 72.00

Sponsor - $ 100.00

Total

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province

Postal Code

Chabad of Hamden

info@jewishhamden.org | 203-635-7268 | P.O. Box 185641 Hamden, CT 06518

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