Full Name* First Name Last Name E-mail Address* I would like to receive news and updates by email Phone Number* Area Code Phone Number Weekend I Will Be Attending* Month Day Year Friday Night Shabbat Meal: Davening is at 7:30pm followed by the Shabbat meal Adults (13+) - Dinner $75/person Children (under 12)- Dinner $50/person Shabbat Day Lunch Meal: Davening is at 10:00am followed by Shabbat meal at 12:30pm Adults (13+) - Lunch $75/person Children (under 12)- Lunch $50/person Payment Chabad of Southern Utah is a branch of the worldwide Chabad Lubavitch Movement. Uniquely each location is funded individually from its own fundraising campaigns and charitable giving of individuals. Your support helps us continue our vital work in providing Judaism and kosher to thousands of local Jews, and visitors like yourself. Please give generously! I Would Like To Partner With Chabad In The Amount Of: $5000 $1000 $770 $500 $360 $180 $100 I Would Like To Request A Discount Request Please put the amount you are requesting to pay. We will see if we can secure a donor to cover the difference of cost. We will get back to you shortly. Please put your credit card in for the full amount and we will refund you the difference after communicating with you. How Much I Am Able To Pay Total $0.00 Yes, I'd like to donate the cost of processing this transaction by adding 3% Payment* Credit Card Paypal eCheck Mail Check Credit Card Visa MasterCard American Express Discover Credit Card Type Credit Card Number Security Code Name on Card 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Expiration Month 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 Expiration Year Paypal has been selected. Payment will take place on the next page. Bank Name Routing Number Account Number Checking Savings Business Account Type Checks can be made out to Chabad of Southern Utah and mailed to 569 E. 200 S. St. George, UT 84770 Billing Address Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Comments? Questions? Submit Should be Empty: This page uses TLS encryption to keep your data secure.