Chabad Central Hebrew School Payment Form
Balance from Statement:
I understand that my credit card will be charged in equal installments beginning on the date this form is submitted.
Please charge my credit for the full amount due.
I will be submitting a check for the full amount and/or checks divided over one dated for now and the others postdated.
City, State, Zip:
Amount to charge:
Name on Card:
Credit card number:
Authorized Signature: (type in name)
Checks can be mailed to: Chabad of Boca Raton 17950 Military Trail Boca Raton, FL 33496
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