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Jewish Art Calendar form

Jewish Art Calendar form

Jewish Art calendar
Special Dates/ Sponsorship form


First Name: Last Name:



City: State: Zip:

Phone: e-mail:


Calendar Sponsorship/ New Year Greeting $180 or other amount $
$180 or more will include your listing on the sponsor's page. Please indicate how you would like your name to appear in the comment box below

Birthdays, Anniversaries, Yartzeits, Special Occasions - $36 per date

Name: Date:

Name: Date:

Name: Date:

Name: Date:

Name: Date:

Calendar Dates

Include the birthday, anniversary, or yahrtzeit of a dear one
(All occasions will be displayed in the calendar on their actual dates)

Payment Information



Visa Master Card American Express

Card Number: Exp. mm/yyyy/

Card ID Number:

Amount to charge to Card

Or you may send a check to:

Chabad Lubavitch of the Quad Cities
2285 St Andrews Cir
Bettendorf, IA 52722


Questions or Comments:

For information or to advertise your business, please contact us at 563.355.1065 or e-mail

Please press Submit to process your request.

For additional names, please submit form again.

Please submit all dates by August 13, 2017.

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