Temple Beth Sholom 2009
High Holy Days Return Form 5770

To charge your card on file, please fill out and submit form below.
Otherwise, print and mail this web page to the TBS Office (address below)
Member's Name A value is required.*required
Member's Phone A value is required.A value is required.*required
Member's Email A value is required.Invalid format.A value is required.*required
DINNERS Qty Cost  
Selichot Dinner
Sept. 12, 6:00 p.m.

$ .00 Adults @ $12 ea.
$ .00 Children (12 & under) @ $8 ea
     
2nd Day Rosh Hashanah Luncheon
Sept. 20, 1:00 p.m.		 $ .00 Adults @ $10 ea.
$ .00 Children (12 & under) @ $7 ea.
     

Simchat Torah/
Consecration Dinner:

Oct. 9, 5:30 p.m.

 $ .00 Adults @ $10 ea.
$ .00 Children (12 & under) @ $7 ea.
     
DONATIONS      
High Holy Day
Flower Fund 		$ .00
$25 Min. 		In honor of: (Rosh Hashanah mention - DEADLINE 9/11)

In memory of: (Yom Kippur mention - DEADLINE 9/18)
High Holy Day
Music Fund 		$ .00
$25 Min. 		In honor of: (Rosh Hashanah mention - DEADLINE 9/11)

In memory of: (Yom Kippur mention - DEADLINE 9/18)
MEMORIAL BOOK DONATION/LISTING

Yom Kippur Memorial Book Listing
(Deadline 9/18)

 $ .00
$25 Min.

 Same as last year
New Listing
Add Names:
Remove Names:

PRAYER BOOK Qty Cost  
Gates of Repentence
(Gender Neutral)
$35/Copy


.00
 To be picked up at the TBS Office
CAMP SHANAH TOVAH RESERVATIONS *required, no fee
Grades 1-6
Camp Shanah Tovah
(Library) 		10:30 a.m. until conclusion of service
BRING SACK LUNCH
Rosh Hashanah Student(s) & Grades (DEADLINE 9/15)
Name: Grade:
Name: Grade:
Name: Grade:
Name: Grade:

Yom Kippur Student(s) & Grades (DEADLINE 9/23)
Name: Grade:
Name: Grade:
Name: Grade:
Name: Grade:

   
CHILD CARE RESERVATIONS *required, $10/Child per session
Infant &
Kindergarten
Child Care 		Bring sack lunch, snack, plus necessary supplies including diapers & wipes.
Sign-in at School Rotunda Entrance. $10/Child per session
Name: Age:
Name: Age:
Name: Age:
  Qty Cost Service
Session 1 $ Erev Rosh Hashanah • Sept. 18, 6 - 8:45 p.m.(DEADLINE 9/15)
Session 2 $ Rosh Hashanah • Sept. 19, 8:30 a.m. until conclusion of service
(DEADLINE 9/15)
Session 3 $ Erev Yom Kippur • Sept. 27, 6 - 8:45 p.m. (DEADLINE 9/23)
Session 4 $ Yom Kippur • Sept. 28, 8:30 a.m. until conclusion of morning service
(DEADLINE 9/23)
Session 5 $ Yom Kippur • Sept. 28, 3:15 p.m. - 6:30 p.m.(DEADLINE 9/23)
Childcare
Totals:		 $  
Total Charges: $    
Please charge my card on file for payment: (Check box)
Comments

Or print and fill out below
NOTE: If you do not receive confirmation of your submission within 2 business days please contact the TBS Office to verify it has been received 714-628-4600
For Printing
and Mailing

Check Enclosed, Amount: $ .00
Charge my : MasterCard / Visa (Circle One)

ONLY : Account Number
  Expiration Date /

Please mail this form back to us at:
Temple Beth Sholom, 2625 N. Tustin Ave., Santa Ana, CA 92705

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