Ayeka 2 - Form - Shma Koleinu

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Ayeka 2

First Name

Last Name

* Address

Address 2

* City, State Zip

Phone

* Email:

* This course is open to all who have taken the Ayeka course with Rabbi Scott and those who haven't, but are open to jumping into a deeper sense of self. We invite all participants to make a suggested contribution of $118 or a different amount. All are invited to contribute more if you are so moved.

Please Select One$118I will choose a different amount below.

If you'd like to contribute an amount that is not listed above, please enter the amount here: (Please write a numerical value, e.g.: 50, 100, etc)

Wed, October 16 2019 17 Tishrei 5780

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