HEAVEN on EARTH A virtual tour of our Holy Temple Three Part Workshop REGISTRATION _________________________________________________________________________________________ I would like to attend the HEAVEN ON EARTH course: Wednesdays 26 June, 3 & 10 July Sandton Central Chabad's Goodness & Kindness Centre 8 Stella St, Sandton 2031 (off West St, across the Gautrain) 7:30pm-9:00pm Course Cost: R200 full course R75 per session Payments can be made via credit card below (processed in our office), or cash payment at the course, or via EFT to our account - FNB Balfour Park, Account number: 62051755886, Brach: 212217, Reference: JLI course + your name - (Course Fee: R200 per person for the entire course or R75 per person if paying per class). Please email your proof of payment immediately to [email protected] - Thank you! Everyone is welcome! No one will be turned away for lack of funds. Bursaries and discounts are available. Email [email protected] for any JLI related inquiries or call Chabad House 011-440-6600 or Raabbi Ari Kievman directly at 079-434-1293. You may also request for this course to be held at a locatiion of your choice. Contact Information _________________________________________________________________________________________ # of Participants registering on this form You may register multiple course participants at the same location with this form. If participants will be attending at different locations, please register each separately. Participant 1 Title First Name Last Name Gender Male Female Address Phone Email Participant 2 Title First Name Last Name First Name Last Name Gender Male Female Address Phone Email Participant 3 Title First Name Last Name First Name Last Name Gender Male Female Address Phone Email Payment Total Amount Card Type Card Number Exp. Date CVV code Comments I would like to make a donation to JLI for others to attend. I would like to attend HEAVEN ON EARTH at the above selected location. How did you hear about JLI? Comments We look forward to see you at the course! If you have any questions call us at 011-440-6600 or email [email protected] __________________________________________________________________________________________ This page uses 128 bit SSL encryption to keep your data secure.
