Registration Please fill out the form and click submit below. ______________________________________________________________________________________ I would like to attend the Toward a Meaningful Life course with Rabbi Ari Kievman: 6 Wednesdays 7:15pm 5 August through 9 September Chabad of Benmore-Riverclub Course Cost: R499 full course or R100 per class TRY THE FIRST CLASS FREE Payments can be made via credit card below (processed at our office), or cash payment at the course, or via EFT to our account - Account number: 62457937989 FNB Balfour Park - Branch : 250-655, Reference: your name - (Course Fee: R499 per person for the entire course or R100 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. Please consdier sposnsoring the costs related to this course. Dedication of entire course is R7,700. Email [email protected] for any JLI related info, call Chabad 011-440-6600 or Rabbi Ari Kievman at 079-434-1293. You may also request for this course to be held at a location of your choice. Full Name* Prefix First Name Last Name E-mail Phone Number - Area Code Phone Number Payment Per Class - R100 Full Course - R499 Sponsor - R7,700 Other Payment Credit Card EFT Credit Card Visa MasterCard Credit Card Type - Credit Card Number Security Code Name on Card 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December / Expiration Month 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Expiration Year See above for our EFT banking details Billing Address Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Total R0.00 ZAR How did you hear about JLI? Comment Should be Empty: Submit This page uses TLS encryption to keep your data secure.
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