Community Purim Party 

Thursday, March 1, 5pm

Senior Center - 1200 Raintree Drive, Fort Collins

Name

Address

Phone Email

 

# of Adults @ $15 # of Children @ $10

 Sponsor @ $100

No-one turned away for lack of funds

 

Total Amount:

I would like to pay via: Check Credit Card

Card type: Card Number

Exp. CVV

Please add 3% to my total to help cover credit card processing charges.

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