Special Occasion - JewishWaukesha.com

Address*

Phone Number

Area Code Phone Number
I would like to contribute towards the publishing of the Chabad of Waukesha-Brookfield Jewish Art Calendar. (In recognition of your kind contribution and mitzvah for the New Year, your name will be included on the Shanah Tovah greetings page of the calendar): $54
Personalize the Calendar with your Special Dates
I would like to include the important dates of my family calendar - birthdays, anniversaries and yartzeits. (Please fill out dates below, each will appear on the actual date of occurrence in our calendar for a donation of $18.00 per date)
Please select an amount of personal dates you would like to be listed in the calendar: $18 per person
Full Name #1

First Name Last Name
Occasion
Occasion Date

Month Day Year
Full Name #2

First Name Last Name
Occasion
Occasion Date

Month Day Year
Full Name #3

First Name Last Name
Occasion
Occasion Date

Month Day Year
Full Name #4

First Name Last Name
Occasion
Occasion Date

Month Day Year
Full Name #5

First Name Last Name
Occasion
Occasion Date

Month Day Year
Full Name #6

First Name Last Name
Occasion
Occasion Date

Month Day Year
Total

$0.00

Payment

Credit Card Check

Postal / Zip Code

Country

This page uses TLS encryption to keep your data secure.