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At Chabad of Palmetto Bay

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Matzah Order Form

Your Information:
Full Name*

First Name Last Name
E-mail*
Phone Number

Area Code Phone Number
Matzah Order:
Handmade Shmurah Matzah (PICKUP AT CHABAD) $30/pound**
Total

$0.00

Payment

Credit Card

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Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

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