Dinner Registration - GNS 73rd Annual Dinner

1 Personal Information

First Name*

Last Name*

Display Name*

Email*

Phone*

Address*

Address 2

City*

Zip*

2 Ad Sizes

Message

OPTIONAL: Do you wish to to provide ad text?

Message

3 Raffle Tickets

1

$25

10

$235

20

$440

50

$1,000

4 Payment Options

Credit Card

Check

Please charge me a total of $ to cover processing fees.

Please make out your check to:
Great Neck Synagogue

Please mail your check to:
Great Neck Synagogue
26 Old Mill Road
Great Neck, NY 11023