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Reservation Contact Details Full Name* First Name Last Name Phone Number* E-mail* Address* Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Dinner ReservationCouvert: $450 | $360 under 40 | Black Tie Optional Feel free to email us at [email protected] or call us 201.476.0157 for any dedication/reservation help. My reservation is for: To see dedication opportunities, please select 'Dinner reservations and dedication' or 'Dedication only" Dinner reservations and dedicationDinner reservation onlyDedication only My reservation is for:* Dinner reservation only Couvert $450$360 Couvert: $450 Input amount of attendees over 40. Thank you so much for you reservations! We are so excited to see you there. Would you be interested in upgrading your reservations? For $300, you can support a good cause and get a Full Page Ad (including your 2 reservations) +$300: Upgrade to Full Page Ad Couvert: $360 Input amount of attendees under 40. Thank you so much for you reservations! We are so excited to see you there. Would you be interested in upgrading your reservations? For $300, you can support a good cause and get a Full Page Ad (including your 2 reservations) +$300: Upgrade to Full Page Ad Select your dedication Full Page ... $750Half Page ... $360Quarter Page ... $250 Select your dinner reservation and dedication Each reservation that includes a table is for a table of 10 or 12 guests. All reservations on this tier entitle you to a full page ad in the journal, and will be placed according to the tier selected. Jerusalem of Gold Sponsor...Includes 2 tables of 10 - $100,000Founders Page...Includes 2 tables of 10 - $75,000Crown Sponsor...Includes 2 tables of 10 - $54,000Pillar of Support...Includes 1 table of 10 - $36,000Benefactor Page...Includes 1 table of 10 - $25,000Corporate Sponsor...Includes 1 table of 10 - $18,000Bar / Bat Mitzvah Page...Includes 1 table of 10 - $13,000Corporate Leader... Includes 1 table of 10 - $10,800Platinum Page...Includes reservations for 2 - $5,400Diamond Page...Includes reservations for 2 - $3,600Chai Page...Includes reservations for 2 - $2,500Gold Page...Includes reservations for 2 - $1,800Silver Page ... Includes reservations for 2 - $1,200 Select your dedication only Full page and above entitles you to a full page ad in the dinner journal. Jerusalem of Gold Sponsor... $100,000Founders Page ... $75,000Crown Sponsor... $54,000Pillar of Support ... $36,000Benefactor Page ... $25,000Corporate Sponsor ...$18,000Bar / Bat Mitzvah Page ... $13,000Corporate Leader ... $10,800Platinum Page ... $5,400Diamond Page ... $3,600Chai Page ... $2,500Gold Page ... $1,800Silver Page ... $1,200Full Page ... $750Half Page ... $360Quarter Page ... $250 Names of all attendees:* All attendees are required for seating purposes Input your ad, either via text below or by uploading a file. If uploading a file, make sure it matches the sizes of our journal. Full Page: 6"x9" Half Page: 6"x4.5" Quarter Page: 3”x4.5” Please seat me with: (We look forward to having you! We will have a seat for you but cannot guarantee preferred placement as the Gala nears in these last days.) See Journal examples here Ad Text Upload Ad Total $0.00 Payment* Payments of $18,000 and above can be paid over two years Credit Card Paypal eCheck Other Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2025202620272028202920302031203220332034 Expiration YearPaypal has been selected. Payment will take place on the next page. Bank Name Routing Number Account NumberCheckingSavingsBusiness Account TypeMail in Check (if paying via personal/business check or donor-advised fund.) Mail checks to: Valley Chabad. 530 Chestnut Ridge Rd. Woodcliff Lake, NJ 07677;Bank Transfer: Pay via Venmo, Stock TransferBilling Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country I would like to receive news and updates from Valley Chabad by email. 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