RegistrationForm

Registration Form

Dinner with a Scholar

Saturday, January 8, 2005

7:15pm

Please fill out this form by December 24th.

If you choose to pay by credit card, the Bureau Office will call you to get the number. If you choose to pay by check, just send it to the Bureau (address below) and write "Dinner with a Scholar" on the memo line.

Name

Address

City, State

Zip

Phone

Minimum donation:$125 per person.

Number of people attending

Total amount: $

I cannot attend, but I would like to make a tax-deductible donation.

Your additional contribution will help make a Bureau program available to more students.

I will send a check.

I want to charge my credit card. Please call me.

Please...

Select three dinners from the boxes below

Please respond by December 24th

Host homes are limited to 20 guests or less

Dr. Marilyn Harran

Brion Jeannette

Rabbi Isaac Jeret

Laurie Levenson

Dr. Stephen and Robbie Prepas

Dr. Uzi Rabi

E. Randol Schoenberg

Dr. Dvora Weisberg

Bureau Alumni Dinner

Please indicate any special dietary needs (i.e. allergies, lactose intolerance), requests (i.e. Kosher) or concerns:

The Bureau will contact you with location address and directions by January 5, 2005

The Zwiren and Levin dinners are in Kosher homes.

Bureau of Jewish Education
of Orange County
E-mail: [email protected]
http://www.bjeoc.org/

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