2026 Dinner Reservation & Ad Form

2026 Dinner & Ad Journal Form

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Would you like to make a Journal Dedication?

Yes

No - I would like to make a reservation only

What level Journal Dedication would you like to make?

Contributions of $1,000 or more include a full-page journal ad and two (2) dinner reservations.

Would you like to pay for your Journal Dedication now?

Yes

No, I will arrange payment with Ahavas Torah later

Journal Dedication Amount

Would you like to upload your ad now?

Yes

No, I will email it to info@ahavastorahmb.com later

Journal Ad File

Accepted file types: jpg, png, pdf, Max. file size: 32 MB.

Reservations WITHOUT Journal Dedication

If you would like to make a Journal Dedication, it includes two (2) dinner reservations. Please do NOT use this field if you are planning on making a Journal Dedication - see the next field below.

Price: $250.00

Payment Information

Payment Method*

Pay by credit card

Pay by Zelle (use the address info@ahavastorahmb.com on Zelle)

Would you like to add an amount to cover the credit card convenience fee?

Yes - let me add a 3% contribution

Additional contribution to cover the credit card convenience fee

Price: $0.00

Total

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Billing Information

Billing Name*

First Last

Billing Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Billing Phone*

Billing Email*

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