Payment Form

Payment Information

Yes! I would like to support the activities of Town of Oyster Bay Chabad

Amount

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Purpose

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Please charge my card monthly for 12 months.

Contact Information

First Name

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Last Name

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Address

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City

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State

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Zip Code

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Phone

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Email

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Credit Card Information

Card Type

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Card Number

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Expiration Date

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Security Code

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Use contact info above

Card Name

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Card Address

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Card Zip Code

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Other Information

Note

In honor of

In memory of