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Nshei Chabad Trip to Rebbe Reservation Form

This form is currently closed.

Full Name
Prefix Full First Name (Bas) Mothers Full Name
Legal Name (on ID for plane tickets)*
First Name Middle Name Last Name
Birth Date*

Month Day Year
Phone Number (cell for whatsapp group)*
E-mail*
Are you bringing a baby/lap child?*

YesNo
Flying info (check all that apply)*

Flying to NY together with the group at 6:00am on Tuesday Morning DTW- JFKFlying back together with the group at 9:15pm on Tuesday Night LGA- DTW
Ride to DTW airport Tuesday Morning *

Carpool from Oak park/SouthfieldCarpool from West BloomfieldI will take care of my own rideI don't know yet... TBD
Ride from DTW airport Tuesday Night*

Carpool to Oak park/SouthfieldCarpool to West BloomfieldI will take care of my own rideI don't know yet... TBD
Any food allergies/restrictions?*

No
Will you be bringing your own food?* If you'll be bringing your own food you'll receive a $30 discount

NoYes
I plan to bring my own food and receive a $30 discount
Is there anything else that we should know that can help make the trip more pleasant for you?
How did you hear about this trip?
Questions or Comments
Would you be interested in helping in any way?
Price options (Not including flight cost) *

Actual Cost - $200Subsidized Cost - $150
Ticket Payment

We will let you know what the final cost of flight is after the tickets are booked. Once we let you know that we have the tickets and the amount, please submit payment at ChabadMI.com/nshei-trip
Please consider making a donation to help subsidize someone who can't afford it

$36$54$100$200
Total

$0.00
Yes, I'd like to donate the cost of processing this transaction by adding 3%

Payment

Credit Card Zelle

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