Detailed schedule of the event – Coming Soon… Personal Information:Name(Required) Prefix Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. First Last Email(Required) Phone(Required) Registration:Full Price Adult - $849 (per person) QuantityIncludes preferential hotel rooms, and accomodations. Price: $849.00 Quantity HiddenFull. price adult - qtyAdults names(Required)Subsidized Price Adult - $525 (per person) QuantitySubsidized pricing EXTENDED through October 11th. Price: $525.00 Quantity HiddenSubsidized Price Adult - qtyAdults names(Required)Children's Price Ages 3-12 - $250 (per child) Quantity Price: $250.00 Quantity Children's Names & Age(Required)Children's Price Ages 2 and under - $50 (per child) Quantity Price: $50.00 Quantity Infants Names & Age(Required)HiddenChildrens 3-12 qtyHiddenChildrens - under 2Rollaway requestsSelect12Crib requestsSelect12High chair requestsSelect12HiddenTotal Quantity - TicketsSingle occupancy - supplemental fee Price: For scholarship information, please email hirschr@ou.org. Requests:Room type(Required)SelectDoubleQueenKingDo you need a connecting room?(Required) Yes No Special dietary requests Sponsorship Info:Would you like to make a tax-deductible donation towards the Semichas Chaver Program?Sponsorship opportunities(Required) Yes, I would like to be a sponsor No, I do not want to be a sponsor Donation Amount Sponsor a Family - $1,800 Sponsor a Couple - $1,050 $500 $360 $180 Other Select Amount(Required) Billing Info:Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Payment Info:For scholarship inquiries, please email hirschr@ou.orgCoupon Discount (10%) $0.00 Discount (20%) $0.00 Discount (30%) $0.00 Total Credit Card(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name
