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Kabala Class Reg.

Kabala Class Reg.


Kabala Class Registration Form

     (This form is secure)

     Last Name*

     First Name*


     Home Address*

     City - State - Zip*:




Payment Options:

 I will mail/bring a $36 Check payable to Chabad of the Central Cascades

 Charge my Credit Card $36 (3% surcharge for paying by credit card)

Credit Card Type: 

Name on Card: 

CC # : 

Exp. Date:    

CVV2(last three digits on back of card): 

Billing Address (if different): 



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