Chicago Community Kollel :: 25th annual banquet Ad Form

First Name*

Last Name*

Address

City

State

Phone

Email*

Ad Options: (please note your ad of $540 or above includes two dinner reservations*

Kavod HaTorah Tribute $2,500 Amud HaTorah $1,800 Parchment $1,000 Gold $540 Silver $360 Full $250 Half $150 Quarter $90

Ad Message*

Payment Option

Please bill me I will send a check I will pay by credit card (you will be able to pay via paypal after you click submit)