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americanuniversityhillel

HIGH HOLIDAY TICKET REQUEST FORM 2011/5772


Ticket Information:
Number of tickets requested _____
Conservative _____ Reform_____
I am (circle one): Community Member
AU Alumni
AU Faculty/Staff
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Contact Information:

Name: ___________________________________________________
Street: ___________________________________________________
City, State ZIP: ____________________________________________
Home Phone: _____________________________________________

I would like to be on the email list for Hillel activities

YES

NO

Email: ___________________________________________________
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Participation Information:

(Name) _________________would like to participate in services in the following way:


___Chant/read Torah
___Chant Haftarah
____Do English reading
___Blow Shofar
___Have an aliyah
____Lift Torah/Tie Torah
___Lead a service
Names of deceased loved ones (parents, siblings, children, spouse only) for Yizkor memorial service on Yom
Kippur: _________________________________
------------------------------------------------------------------------------------------Contribution Information (requested minimum $150/person, $300/family):
Additional donations are encouraged.
Please make checks payable to AU Hillel.
OR Please complete the section below for payment via credit card.

MASTERCARD/VISA Number_______________________________ Exp. Date_________Sec. Code_________


Name on Card________________________________________ Total $______________
Phone Number_____________________________ Signature _____________________
Please include a self-addressed, stamped envelope for faster ticket processing.

TO ENSURE DELIVERY, ALL TICKET REQUESTS ARE DUE BY Friday, September 9, 2011
(after that date tickets can be picked up at our office or at services)

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