Full Name* First Name Last Name E-mail* Phone Number* Area Code Phone Number I am Attending: Menorah Lighting Launceston Sunday 28th Nov 7:00pm #1 #2 #3 #4 #5 #6 #7 Chanukah Celebration North West Tuesday 30th Nov 6:30pm #1 #2 #3 #5 #6 I want to sponsor $18 AUD $36 AUD $50 AUD $180 AUD Total Charge $0.00 AUD Payment Method Credit Card Paypal Direct Deposit Credit Card Visa MasterCard American Express Credit Card Type Credit Card Number Security Code Name on Card 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Expiration Month 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 Expiration Year Paypal has been selected. Payment will take place on the next page. BSB: 087 728 ACCOUNT NUMBER: 55526 3381 Comments? Questions? I would like to receive news and updates by email Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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