1. Personal InformationFull Name*First NameLast NameE-mail*I would like to receive news and updates by emailPhone Number *Area CodePhone Number2. Choose Your KiddushDate of KiddushMonthDayYear In memory/honor ofChoose Kiddush PackageKiddush Options*Choose A Package$36 - DIY Kiddush$100 - Chamin$125 - Gefilte Fish$125 - Schnitzel Bowl$150 - Lox & Bagels$150 - Meatballs & Spaghetti$150 - Tuna/ Egg Salad$175 - SalmonBuild-a-Kiddush3. PaymentTotal$0.00 USDSpecial InstructionsPayment*Credit Card Paypal Check/Cash Credit CardWe accept Visa, MasterCard, American Express, DiscoverCredit Card NumberSecurity CodeName on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberExpiration Month2023202420252026202720282029203020312032Expiration YearPaypal has been selected. Payment will take place on the next page.Submit Clear FormShould be Empty: This page uses TLS encryption to keep your data secure.