Membership Dues - Form - Congregation Havurah Shalom

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Membership Dues

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Total: $50 per person

Please select a quantity of 1 if an individual, else 2 if joining as a couple

* Quantity

* Type of Donation

Please Select OneMembership Dues

* First Name

* Last Name

* Phone number where you can be reached.

* Email Address (also used as username to login to CHS website)

Your special instructions:

Mon, November 30 2020 14 Kislev 5781

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