Let's Talk About Dying: The Before, During and After

Co-taught by Rabbi Splansky and Cynthia Good

Thursdays: May 7, 14 and 21

1:00 - 2:00 PM

In-person @HBT & Virtually

Registration Information

Pronouns

Please specify

First Name

Last Name

Why are we asking for pronouns? https://urj.org/quick-guide-pronouns

Email Address

Are you a member at Holy Blossom Temple?

YesNo

Are you affiliated with another congregation?

YesNo

Congregation Name

I will be attending

In-person Virtually

How many additional guests will be joining you?

Guests

1. Name

2. Name

3. Name

4. Name

I would like to make a contribution to programming at Holy Blossom Temple

Contribution Details

Total Contribution

Please help offset credit card processing fees by contributing an additional 2.8%

YesNo

Adjusted Total

2.8% Fee

Total Contribution

Please list your name(s) as you would like them to appear in the Temple Bulletin or write ‘anon’ if the gift is anonymous.

Credit Card Information

First Name

Last Name

Billing Address

Billing City

Billing Province

Billing Postal Code

Billing address must match the address associated with the credit card.

Credit Card Number

Visa or Mastercard

Expiry Month

Expiry Year

CVV

Tax Receipting

All donations will be tax receipted in February of the following year by email
Tax receipts will be issued for donations of $18 or more

Invoice Name

Authnet_Hidden_Fields

Invoice Req'd

YesNo

Final Contribution