Hospitality Suite Request Form

Full Name*

First Name Last Name
Primary Phone Number*

Area Code Phone Number
E-mail*
City/State of Residence*
Congregation Affiliated With?*
Please list the name and number of a Rabbi/Rebbetzin as a reference*
Purpose of your Visit*
When would you like to stay with us?
From*

Month Day Year
To*

Month Day Year
How Many Adults?*

If you will have children with you, please include their ages and gender with your references below.
How Many Children?*

If you will have children with you, please include their ages and gender with your references below.
Any special food requirements Please check all that apply so we can best accommodate your stay

AllergiesCholov YisroelPas YisroelVegeterianOther
If you have selected Allergies or Other, please detail
Weeknight Stays for 2 Adults

Weeknight reservation rates are $70 per night.
Shabbat Package for 2 Adults

Our Shabbat Package rate is $218 and includes the following:

Early check-in on Friday and late check-out on Sunday morning

Light refreshments (Pas Yisroel) and milk/non-dairy creamer

Friday night dinner in the home of one of our congregants

Shabbat lunch (wash & sit full Kiddush at Shul)

Hot water urn for coffee/tea

Shabbat lamp

Havdallah Package
Please note that this form does not guarantee your reservation. A follow up phone call or email will confirm your stay with us.
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Please note that this form does not guarantee your reservation. A follow up phone call or email will confirm your stay with us.