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	Shofar in the Park - Chabad of Southern Minnesota
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<form class="userform-form" action="" method="post" name="form_5210792" id="5210792" accept-charset="utf-8"><input type="hidden" name="formID" value="5210792" /><div class="form-all dir_ltr" dir="ltr"><ul class="form-section"><li id="cid_40" class="form-input-wide"> <div class="form-header-group"><h2 id="header_40" class="form-header">Shofar in the Park Wednesday, September 24th 5:00pm (RSVP for Location)</h2></div> </li><li class="form-line" id="id_41"><div id="cid_41" class="form-input-wide"> <div id="text_41" class="form-html"><p><span style="font-size:18px;">A family-friendly Shofar in the Park with sounding of the Shofar, music, and the sweet taste of a new year together.</span></p>
</div> </div></li><li class="form-line" id="id_1"><div class="form-label-left" id="label_1"><label for="input_1"> Full Name<span class="form-required">*</span> </label><label class="label-message" for="input_1"> </label></div><div id="cid_1" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q1_fullName[first]" id="first_1" autocomplete="given-name" />  <label class="form-sub-label" for="first_1" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q1_fullName[last]" id="last_1" autocomplete="family-name" />  <label class="form-sub-label" for="last_1" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_3"><div class="form-label-left" id="label_3"><label for="input_3"> E-mail<span class="form-required">*</span> </label><label class="label-message" for="input_3"> </label></div><div id="cid_3" class="form-input"> <input type="email" class=" form-textbox validate[required, Email]" id="input_3" name="q3_email" size="30" value="" autocomplete="email" /> </div></li><li class="form-line" id="id_31"><div class="form-label-left" id="label_31"><label for="input_31"> Phone Number </label><label class="label-message" for="input_31"> </label></div><div id="cid_31" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[Numeric]" type="tel" name="q31_phoneNumber[area]" id="input_31_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_31_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[Numeric]" type="tel" name="q31_phoneNumber[phone]" id="input_31_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_31_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li id="cid_35" class="form-input-wide"> <div class="form-header-group"><h2 id="header_35" class="form-header">Can we add your name to the Caring Wall?</h2><div id="subHeader_35" class="form-subHeader">Participation in Chabad of Southern Minnesota's High Holiday services is free of charge; Our doors are open to everyone, with no membership or tickets on the High Holidays or any day of the year. Chabad relies on voluntary High Holiday contributions to fund all of our services, children's program and cantors.Your support helps cover the costs of these and other wonderful and vital programs that Chabad of Southern Minnesota brings to your community.The total cost for all the High Holiday programs is more than $40,000.  Can we add your name to the Caring Wall?Thank you for your support!</div></div> </li><li class="form-line" id="id_36"><div id="cid_36" class="form-input-wide"> <img alt="" class="form-image" border="0" src="https://w2.chabad.org/media/images/1289/cKgg12898804.png" height="512.0500000000001" width="665" /> </div></li><li class="form-line" id="id_39"><div class="form-label-left" id="label_39"><label for="input_39"> Number of Atendees </label><label class="label-message" for="input_39"> </label></div><div id="cid_39" class="form-input"> <input type="number" autocomplete="nope" id="input_39" name="q39_input39" data-type="input-spinner" class="form-spinner-input form-textbox" /> </div></li><li class="form-line" id="id_33"><div class="form-label-left" id="label_33"><label for="input_33"> Donation </label><label class="label-message" for="input_33"> </label></div><div id="cid_33" class="form-input"> <div class="form-multiple-column" data-columns="2"><span class="form-radio-item"><input type="radio" class="form-radio" id="input_33_0" name="q33_input33" value="7200" /><label for="input_33_0"><span>$7200</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_33_1" name="q33_input33" value="5400" /><label for="input_33_1"><span>$5400</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_33_2" name="q33_input33" value="3600" /><label for="input_33_2"><span>$3600</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_33_3" name="q33_input33" value="1800" /><label for="input_33_3"><span>$1800</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_33_4" name="q33_input33" value="1080" /><label for="input_33_4"><span>$1080</span></label></span><span 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</label></div><div id="cid_34" class="form-input"> <table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2" class="form-payment-methods form-multiple-column"><span class="form-radio-item"><input class="paymentMethod form-radio validate[paymentMethod] form-radio" type="radio" id="input_34_creditCard" name="q34_payment[payment_method]" value="creditCard" onclick="BuildSource.creditCard(this)" /><label for="input_34_creditCard">Credit Card</label> </span><span class="form-radio-item"><input class="paymentMethod form-radio validate[paymentMethod] form-radio" type="radio" id="input_34_other" name="q34_payment[payment_method]" value="other" onclick="BuildSource.other(this)" /><label for="input_34_other">Mail-in Check, Invoice</label> </span></td></tr><tr class="credit_card hide"><th colspan="2">Credit Card</th></tr><tr class="credit_card hide"><td colspan="2" style="padding:0"><table cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2"><span class="form-sub-label-container">  <label class="form-sub-label">We accept Visa, MasterCard, American Express, Discover</label></span><div class="cc-icons"><div class="cc-icon visa-icon"></div><div class="cc-icon mastercard-icon"></div><div class="cc-icon amex-icon"></div><div class="cc-icon discover-icon"></div></div><input type="hidden" name="q34_payment[cc_type]" id="input_34_cc_type" value="" /></td></tr><tr><td><div class="cc-field-wrapper"><span class="form-sub-label-container"><input class="form-textbox form-creditcard js-cc-number validate[visible, creditcard]" type="text" name="q34_payment[cc_number]" id="input_34_cc_number" autocomplete="cc-number" size="20" />  <label class="form-sub-label" for="input_34_cc_number" id="sublabel_cc_number">Credit Card Number</label></span></div></td><td class="cc_ccv "><span class="form-sub-label-container"><input class="form-textbox validate[visible]" type="text" name="q34_payment[cc_ccv]" id="input_34_cc_ccv" autocomplete="cc-csc" size="6" />  <label class="form-sub-label" for="input_34_cc_ccv" id="sublabel_cc_ccv">Security Code</label></span></td></tr><tr><td colspan="2" class="cc_name_on_card "><span class="form-sub-label-container"><input class="form-textbox validate[visible]" type="text" name="q34_payment[cc_nameOnCard]" id="input_34_cc_nameOnCard" autocomplete="cc-name" size="33" />  <label class="form-sub-label" for="input_34_cc_nameOnCard" id="sublabel_cc_nameOnCard">Name on Card</label></span></td></tr><tr class="credit_card hide"><td colspan=""><span class="form-sub-label-container"><select class="form-textbox validate[visible]" name="q34_payment[cc_exp_month]" id="input_34_cc_exp_month" autocomplete="cc-exp-month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_34_cc_exp_month" id="sublabel_cc_exp_month">Expiration Month</label></span></td><td><span class="form-sub-label-container"><select class="form-textbox validate[visible]" name="q34_payment[cc_exp_year]" id="input_34_cc_exp_year" autocomplete="cc-exp-year"><option></option><option value="2025">2025</option><option value="2026">2026</option><option value="2027">2027</option><option value="2028">2028</option><option value="2029">2029</option><option value="2030">2030</option><option value="2031">2031</option><option value="2032">2032</option><option value="2033">2033</option><option value="2034">2034</option></select>  <label class="form-sub-label" for="input_34_cc_exp_year" id="sublabel_cc_exp_year">Expiration 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id="input_34_state" autocomplete="billing address-level1" />  <label class="form-sub-label" for="input_34_state" id="sublabel_34_state">State / Province</label></span></td></tr><tr class="billing_address hide"><td width="50%"><span class="form-sub-label-container"><input class="form-textbox form-address-postal" type="text" name="q34_payment[postal]" id="input_34_postal" size="10" autocomplete="billing postal-code" />  <label class="form-sub-label" for="input_34_postal" id="sublabel_34_postal">Postal / Zip Code</label></span></td><td><span class="form-sub-label-container"><select class="form-dropdown form-address-country" name="q34_payment[country]" id="input_34_country" autocomplete="billing country-name"><option value="" selected="selected">Please Select</option><option value="United States">United States</option><option value="Afghanistan">Afghanistan</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="American Samoa">American 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