JOTS Course Sign-up

This form is currently closed.

Six Tuesdays | February 25th - April 1st | 7:30 PM
Chabad of Parkland
(Location subject to change)
Full Name*
First Name Last Name
My spouse will attend as well
First Name Last Name
E-mail*
Spouse's E-mail
Phone Number*

Address*

Text Book Fee*

$30
Additional Text Book for spouse It is preferable for each person to have their own text book

$30
Suggested donation

$72I'd like to a class sponsor $360I'd like to be a course sponsor $770
Total

$0.00

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

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