This form is currently closed. Kaparot is a Jewish custom in preparation for Yom Kippur. Kaparot will be performed with live chicken on your behalf , part of the funds collected will go toward assisting needy families in our community. This form should be submitted before Monday, September 29th Midnight. After this time Kaparot will be performed solely by Tzedakah . May you and your family be inscribed and sealed for year of health ,blessing and revealed goodness. Full Name* First Name Last Name Hebrew names* Name Mothers name Specify Male/Female Name Mothers name Specify Male/Female Name Mothers name Specify Male/Female Name Mothers name Specify Male/Female If you have more names please write them here. NAME ben/bat MOTHERS NAME E-mail* Phone Number* Select below the right amount: 1 Chicken - $36 2 Chickens -- $72 3 Chickens -- $108 4 Chickens -- $144 5 Chickens -- $180 6 Chickens -- $216 Amount (36$ per chicken)* $36 USD$72 USD$108 USD$144 USD$180 USD$216 USD Suggested Donation for CPY $180 USD$360 USD$720 USD$1260 USD$1800 USD Total $0.00 USD Payment* Credit Card Paypal 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. Should be Empty: This page uses TLS encryption to keep your data secure.
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