Couvert: $600 per Couple • Ad Journal Deadline: Thursday, December 4, 2014 Reservations & Seating Dinner reservations & Journal: people will attend. Names of persons attending I/we prefer to be seated with Dinner reservations only: people will attend. Journal Ad only: Please submit ad info below Dinner Tribute Journal We invite you to place an ad in our 2014 Celebration Journal as a way to support the activities of Chabad of the Five Towns. You may consider either a business advertisement; or messages honoring the Honorees, Committee Members; or in memory of a loved one. Advertising contributions are tax deductable to the maximum permitted by law. I/WE WISH TO HAVE MY ADVERTISEMENT OR MESSAGE APPEAR ON THE FOLLOWING TYPE OF PAGE: Double Chai Builder | $36,000 Chai Page | $1,800 Grand Master Builder | $25,000 Gold Page | $1,000 Master Chai Builder | $18,000 Silver Page | $770 Master Crown Builder | $10,000 Full Page | $600 Includes dinner reservations for two Crown Page | $5,000 Half Page | $360 Diamond Page | $3,600 Quarter Page | $250 Platinum Page | $3,000 Includes dinner reservations for a table of ten Business Card Listing | $125 My/Our ad is in honor of: Mr. & Mrs. Shlomo & Addi Kapetas Mr. & Mrs. Leonard & Phyllis Lubin Mr. & Mrs. Yosef Y. & Penina B. Popack Mr. & Mrs. Shmuel & Estee Salman Mr. & Mrs. Shlomo & Ahuvas Slatus Dinner Chairmen Chabad of the Five Towns Other **To send artwork, email [email protected] Please print your message below: Payment Card Information If you wish to pay with a check, please fill out this form, print and mail it together with a check to: Checks should be made payable to Chabad of the Five Towns and mailed to 74 Maple Avenue Cedarhurst, NY 11516 Total Amount Credit Card Type Please Select Visa Mastercard Card Number Exp. Date Month 01 02 03 04 05 06 07 08 09 10 11 12 Year 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Cvv Code Contact Information First Name Last Name Address City / State / Zip Phone Email