eoregae/off e%age Oiam

Peo,bis Yeate gad

I Ptesefft

tcoac(---a-eg

eo

/00#ifeitae

c.f./4- ad (;,,e-eo-deffenauceor)

d eactu4,

COic

1/Cir

aka-

Yeuriag, 6:0 0 / 0,1 f r,

Atfrelfrietc 74 2003

For Reservations please fill out and return this form with your payment to:

Congregation Chaye Olam • 4875 W. Maple Rd. • Bloomfield Township, MI 48302

Name

Phone

Address

City

Visa/MasterCard #

# of Chicken

Zip

10/24
2003

44

-

-

Exp. Date

# of Whitefish

# of Vegetarian

I would like to be seated with

# of Tickets

Coregat/off C4age Olam Yoe/all/all
/fad at /deep-
4875 gee
4cOths/off,' (.875 / PeP IN"coff
/ffelacle,s ull;re, 4az, s c(1 oetaw,s, c(//ffefi-
(coeta7 laws oisawci)
Z4vreci seatisffm coeltai ate•fe
iees'actfrat/offs,• 218 857 ea (7485)

at $75.00 per person

(Total Amount Due)

PEOPLES
STATE BANK

• .4.

•

We Put People First

Farmington Hills • Grosse Pointe Woods • Hamtramck

Madison Heights • St. Clair Shores • Southfield

Sterling Heights • Warren

1-888-876-4545

www.psbnetbank.com

Member FDIC

769889

