Register for L'Chaim!Name* First Last Email Address* Phone*Tickets* VIP Pre-Party and L’Chaim! - $218 L’Chaim! - $118 Please select your entrée choice*ChickenVegetarianDo you have any dietary restrictions?Would you like to be a Friends of L'Chaim! Sponsor? (fully tax deductible)For a $250 donation, your name (or your company’s name) will be displayed on the welcome screen and included in the thank-you you for attending email Yes No Sponsorship Price: Name for Friends of L'Chaim! Sponsor* First Last Would you like to sign up a guest with your registration?* Yes No Number of Guests*123Guest 1Guest 1 Tickets* VIP Pre-Party and L’Chaim! - $218 L’Chaim! - $118 Guest 1 Name* First Last Guest 1 Email Guest 1 Phone NumberGuest 1 Entrée Choice*ChickenVegetarianGuest 1 Dietary RestrictionsGuest 2Guest 2 Tickets* VIP Pre-Party and L’Chaim! - $218 L’Chaim! - $118 Guest 2 Name* First Last Guest 2 Email* Guest 2 Phone Number*Guest 2 Entrée Choice*ChickenVegetarianGuest 2 Dietary RestrictionsGuest 3Guest 3 Tickets* VIP Pre-Party and L’Chaim! - $218 L’Chaim! - $118 Guest 3 Name* First Last Guest 3 Email* Guest 3 Phone Number*Guest 3 Entrée Choice*ChickenVegetarianGuest 3 Dietary RestrictionsAdditional InformationI would like to sit with the following people:Would you like to opt-in to receive text messages from Jewish Federation? I agree to receive text messages from Federation. PaymentBilling Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Expiration Date Security Code Cardholder Name Transaction Fee Yes! I would like to help Federation by covering the 2.5% credit card processing fee. Credit Card Processing Fee Price: $0.00 Your Total $0.00 Please make sure all required fields are completed. Once you hit submit, you will receive a confirmation email. If you don’t receive an email, please contact us at WP@JFedSTL.org. Δ