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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)
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