Your Information: Full Name* First Name Last Name Address Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Phone Number Area Code Phone Number E-mail* High Holidays Reservations Please check all that apply. Number of attendees: ROSH HASHANAH: Monday Evening, September 22nd Evening Service: 7:00pm 9/22 Evening Service number of attendees: Tuesday, September 23rd Morning Service: 9:00amPower Hour with Rabbi Mendel: 10:45amShofar Blowing & Tashlich in the Park: 6:00pm - Holcomb Bridge Park 9/23 Morning Service number of attendees: 9/23 Power Hour number of attendees: 9/23 Shofar Blowing & Tashlich in the Park number of attendees Wednesday, September 24th Morning Service: 9:00 am 9/24 Morning Service number of attendees: YOM KIPPUR: Wednesday, October 1st Kol Nidrei: 7:00 pm 10/1 Kol Nidrei number of attendees: Thursday, October 2nd Morning Services: 9:00 amPower Hour with Rabbi Mendel: 11:15 am - 12:15 pmYizkor Memorial Service: 12:15 pmMincha and Ne’ilah: 5:00 pm 10/2 Morning Service number of attendees: 10/2 Power Hour with Rabbi Mendel number of attendees: 10/2 Yizkor Service number of attendees: 10/2 Mincha & Neilah number of attendees: Select a seat reservation category: Standard: FreeHigh Holiday Single: $72High Holiday Family $108Chai Donor $180Supporter $360Supporting Partner $540Patron $1080Chai Supporter $1800Supporter Benefactor $5400 Names of all attendees: ROSH HASHANA DINNER - RESERVATIONS ARE NOW CLOSED. I/we look forward to attending the dinner. I have a promo code: YesNo Please enter your promo code: Number of Young Professionals attending Rosh Hashana Dinner: Number of adults attending Rosh Hashana Dinner: Number of children attending Rosh Hashana Dinner: Names of all attendees: I would like to join as a Holiday dinner sponsor: $180 Children's Program I would like to register my children for the High Holiday childcare/program. Tuesday, September 23rd, Rosh Hashanah 1. Childcare: 12:00 - 1:00 PM2. Children's Program 11:00 AM - 12:00 PM Number of children joining child care on 9/23: $10/child Wednesday, September 24th, Rosh Hashanah 1. Children's Program: 11:15-12:00PM Number of children joining child care on 9/24: $10/child Yom Kippur, October 2nd 1. Childcare: 12:00 - 1:30 PM2. Children's Program: 11:00 AM-12:00 PM Number of children joining child care on 10/2:* $10/child Names of all children attending:* Additional Opportunities Please select: I would like to VolunteerI would like to reserve Pesichah/Opening of the Ark for $54.00 (Attendance not required)Please reserve a Lulav and Etrog set for me @$60 a set. Pick up times and locations on Sunday, September 5: 10:00 - 10:30 AM - Chabad Enrichment Center, 6251 Smithpoint Dr # B Peachtree Corners, GA 3009212:00 - 12:30 PM - Suwanee City Hall, 330 Town Center Ave, Suwanee, GA 300242:00 - 2:30 PM - Lawrenceville City Hall, 70 S Clayton St., Lawrenceville, GA 30046 Yartzeit listings: $36 Individual Listing, specify amount below.$180 Full Page Dedication (enter in box below)Same listings as last year. Number of individual listings:* Full Page Dedication:* 1. Name 1. Date of Passing Month Day Year 2. Name 2. Date of Passing Month Day Year 3. Name 3. Date of Passing Month Day Year 4. Name 4. Date of Passing Month Day Year Contributions: We would like to contribute for my/our participation in Chabad’s High Holiday Services: $ Sponsorship Opportunities - Your Donation Has a Big Impact I would like to sponsor Yom Kippur Break-fast - $500I would like to sponsor a Rosh Hashana or Yom Kippur Service - $1,800I would like be a Gold High Holiday Sponsor - $3,600 My Donation is: In HonorIn Memory Of: Total $0.00 Payment Credit Card Paypal Check Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2025202620272028202920302031203220332034 Expiration YearPaypal has been selected. Payment will take place on the next page.Billing Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Additional Comments: Submit Should be Empty: This page uses TLS encryption to keep your data secure.