Ohr Torah 2017 Seat Reservation Form

Today is Friday, August 18, 2017. The deadline for this form is August 22, 2017.

All fields with * are required

Please enter your FIRST name *
Please enter your LAST name *
Please enter your e-mail address *
Please enter your house number and street *
Please enter your city, state and zip *
Please enter your phone number *
  
I am a: Full Member Single Member Associate Member Non-Member


Seat Full Name for Each Individual Gender Household member? Hashkama? Usage Seat Charge
1 Male Female Yes No Yes No RH and YK RH only YK only
2 Male Female Yes No Yes No RH and YK RH only YK only
3 Male Female Yes No Yes No RH and YK RH only YK only
4 Male Female Yes No Yes No RH and YK RH only YK only

Totals: Seats Male/Female Household member? Hashkama total Usage total Seat Charge total



CategoryCharges for all seats
Members and Immediate Household (includes unmarried students)$65 per seat, first 2 seats*; $85 additional seats
Other non-resident family guests$110 all seats
Associate members (as available)$200 all seats
Non-members (as available)$250 all seats

*Full membership comes with two seats; single membership comes with one seat.

Comments and special needs: