High Holiday 5786

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* Last Name

* First Name

Address (for non members only)

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If your account is in arrears, and you do not have a payment plan, your seat assignment will be delayed until arrangements are made.

* Are you a member of the White Shul?

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Please select the number of seats you want from the drop down below.

Adult total seats @ $125/ seat

Adult total seats @ $175/ seat

Total Children under age 18 @ $50/ seat

Total Children under age 18 @ $80 / seat

Enter the name and select the location for each seat you are requesting.

Please select from the following

	Name	Location	When	Requests	Notes

Please let us know if there are any special requests:

By clicking this box, you are making a voluntary additional contribution of $25 per family to cover the increased cost of safety and security.

Total Due:

Total Due

Wed, August 20 2025 26 Av 5785

***** OUR EMERGENCY PHONE NUMBER IS (718) 327-0500 X7*****

728 Empire Avenue, Far Rockaway, NY 11691 ~ (718) 327-0500 ~ Fax: (718) 327-7415