Event Payment Form

Please submit your payment here
Thank you for choosing Lubavitch Aventura South to host your event. We look forward to working with you.
Full Name*

First Name Last Name
If name on reservation is different

First Name Last Name
E-mail*
Phone Number*

Area Code Phone Number
EVENT DATE*

Month Day Year
Payment Type 3% Processing Fee Will be Added to the Total

Deposit $500Event BalanceShloshim/Yarhzeit
Invoice Amount* 3% Processing Fee will be added to the total

$

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

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Postal / Zip Code

Country

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