>> Please do not press "Return" or "Enter" until form is complete <<


Your Name (required)

Your Email (required)

Your Address

Number/Street
City, State
Zip

Your Telephone (with area code):

Please reserve meals for the Passover Seder on Friday, April 22, 2016

KBS members-adults @ $60.00 per plate = $

KBS members-children(6-13) @ $30.00 per plate = $

KBS non-member adults @ $75.00 per plate = $

KBS nonmember children (6-13) @ $37.50 per plate = $

Children (under 6) no charge = $ n/c

TOTAL RESERVATION COST = $

Membership (Single $270 - Family $360 - Sustaining $540) = $

I will pay using:

Click the "Send" button to submit your reservation


Then proceed to the next section for payment.

RESERVATIONS AND PAYMENT MUST BE RECEIVED BEFORE APRIL 15 TO ENSURE SEATING

paypal_donate_button
To pay with PayPal click the "Donate With PayPal" button on the right. Enter the amount and log in to complete the payment. On the second Paypal page please include PASSOVER SEDER 2016 in “Special instructions to the Seller”.

To pay by check
make payable to Congregation Kona Beth Shalom and mail to:
Michael Bernstone
P.O. Box 383205
Waikoloa, HI 96738

RESERVATIONS AND PAYMENT MUST BE RECEIVED BEFORE APRIL 15 TO ENSURE SEATING