Full Name* First Name Last Name Address* Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Phone Number* Area Code Phone Number E-mail* Kiddush OptionsPlease choose one of the three options below, and choose your selections from the drop down menus of that option. Option 1 Dairy/Parave Kiddush $180 Bagels Lox Cream Cheese Pickles, Olives, Onion, Tomato Vegetarian Cholent with KishkaKugel (Potato, Sweet Noodle, Butternut Squash/Pumpkin Pie) OR Pasta Salad (Sesame Noodles, Tomato Basil Pasta, Sweet Vinegar)Dip (Babaganoush, Olive, Red Pepper, Chummus/Techina, Dill) Fruit OR Babka OR Cake Kugel OR Pasta Salad Please make your selection from the drop down menu Please SelectPotato - KugelSweet Noodle - KugelButternut Squash/Pumpkin Pie - KugelSesame Noodles - Pasta SaladTomato Basil Pasta - Pasta SaladSweet Vinegar - Pasta Salad Dip Please make your selection from the drop down menu Please SelectBabaganoushOliveRed PepperChummus/TechinaDill Fruit OR Cake OR Babka Please make your selection from the drop down menu Please SelectFruitCakeBabka Option 2 Dairy/Parave Kiddush $180 Challah Rolls OR BagelsGefilte Fish OR White Fish Salad Tuna Salad Egg Salad Pickles, Olives, Onion, TomatoVegetarian Cholent with Kishka Kugel (Potato, Sweet Noodle, Butternut Squash/Pumpkin Pie) OR Pasta Salad (Sesame Noodles, Tomato Basil Pasta, Sweet Vinegar)Dip (Babaganoush, Olive, Red Pepper, Chummus/Techina, Dill)Fruit OR Babka OR Cake Challah Rolls OR Bagels Please make your selection from the drop down menu Please SelectChallah RollsBagels Gefilte Fish OR White Fish Salad Please make your selection from the drop down menu Please SelectGefilte Fish White Fish Salad Kugel OR Pasta Salad Please make your selection from the drop down menu Please SelectPotato - KugelSweet Noodle - KugelButternut Squash/Pumpkin Pie - KugelSesame Noodles - Pasta SaladTomato Basil Pasta - Pasta SaladSweet Vinegar - Pasta Salad Dip Please make your selection from the drop down menu Please SelectBabaganoushOliveRed PepperChummus/TechinaDill Fruit OR Cake OR Babka Please make your selection from the drop down menu Please SelectFruitCakeBabka Option 3 Deli Kiddush $360 Challah RollsDeli Platter (a choice of 3: Pastrami, Corn Beef, Smoked Turkey, Bologna, Salami)Potato Salad or ColeslawKugel (Potato, Sweet Noodle, Butternut Squash/Pumpkin Pie, Pumpkin Muffins)Pasta Salad (Sesame Noodles, Tomato Basil Pasta, Sweet Vinegar) Vegetarian Cholent with Kishka2 Dips (Babaganoush, Olive, Red Pepper, Chummus/Techina, Dill) Pickles, Olives, Onion, TomatoFruit Cake OR Babka Kugel Please make your selection from the drop down menu Please SelectPotato Sweet Noodle Butternut Squash/Pumpkin Pie Pasta Salad Please make your selection from the drop down menu Please SelectSesame Noodles Tomato Basil Pasta Sweet Vinegar Potato Salad or Coleslaw Please make your selection from the drop down menu Please SelectPotato SaladColeslaw Deli Platter (choice of 3) Please SelectPastramiCorn BeefSmoked TurkeyBolognaSalami Deli Platter 1 Please SelectPastramiCorn BeefSmoked TurkeyBolognaSalami Deli Platter 2 Please SelectPastramiCorn BeefSmoked TurkeyBolognaSalami Deli Platter 3 2 Dips Please make your selection from the drop down menu Please SelectBabaganoushOliveRed PepperChummus/TechinaDill Cake OR Babka Please make your selection from the drop down menu Please SelectCakeBabka For the week of* Please choose the week you would like to sponsor your Kiddush Month Day Year In Honor/memory of Total $0.00 Payment Credit Card Check Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration YearPlease mail checks payable to Chabad Jewish Center, 23665 Moulton Pkwy, #D, Laguna Hills, CA 92653 Notes I would like to receive news and updates by email Submit Clear Form Should be Empty: This page uses TLS encryption to keep your data secure.
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