Tzivos Hashem Registration Fee
Please use this form to pay the Tzivos Hashem registration fee for Pre 1A talmidim. There is a $50 fee per student. Thank you
Contact Information
Title
- Select title -
Mr.
Mrs.
Ms.
Dr.
Mr. & Mrs.
Dr. & Mrs.
Rabbi
Rabbi & Mrs.
First Name
Last Name
Address
City
State
Zip
Phone
Email
Pre 1A Student Name
Donation Information
Amount
$50 - Tzivos Hashem registration fee
Credit Card Information
Type
Visa
MC
Amex
Discover
Number
Expiration
- Choose month -
1 - January
2 - February
3 - March
4 - April
5 - May
6 - June
7 - July
8 - August
9 - September
10 - October
11 - November
12 - December
- Choose year -
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
Code
Use contact info above
Name
Address
Zip
Comments
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