Anshei Shalom
High Holydays Seating Application - 5779

Registered Charity Number: 1100912

Please address all correspondence to:  Anshei Shalom, PO Box 59354, London NW8 1FX 
Email: info@ansheishalom.org.uk; web address: anshei-shalom.com

Please complete this form if you require allocated seating for Rosh Hashannah (Mon 10th and Tue 11th September) and Yom Kippur (Wed 19th September). Please note that space is always limited and therefore seat allocations will be on a first come first served basis. We accept seat allocation requests from members and non-members. However, requests from members will be given priority.

Surname		
Forename(s)		
Address 		
Town		
Postal Code		
Telephone 		
E-mail		

Rosh Hashannah 1st Day		Number of Seats Required:  male:.......  female:......

Rosh Hashannah 2nd Day		Number of Seats Required:  male:.......  female:......

Yom Kippur				Number of Seats Required:  male:.......  female:......

Please list the names of all those requiring seats:
(Please note that we are happy to accept applications for seats for young children but allocations will depend on availability and applications from adults and older children will take priority)

Full Name	Date of Birth (if under 18)	

		

		
Payment:
Members of Anshei Shalom:		No charge

Non-Members:	We ask for a voluntary donation of £120 per person per day, or £230 per person for all 3 days

I enclose a cheque/ have arranged bank transfer for 		£............
Account details:	Account Name: Anshei Shalom; Bank Leumi West End Branch; 
Sort Code:  30-14-95; Account Number: 45419001	

(If you are a UK taxpayer please confirm that you have completed the Gift Aid form in favour of Anshei Shalom. If in doubt, please complete the Gift Aid form again)