Order Form Full Name* First Name Last Name Phone Number* Area Code Phone Number E-mail Dine-inTake-out Dine-in time* 5 pm6 pm Take-out time 5 pm5:15 pm5:30 pm5:45 pm6 pm6:15 pm6:30 pm6:45 pm7 pm Matzah Ball Soup $6 Mushroom Barley Soup $6 Tomato Cabbage Beef Soup $6 Soup Medley $10: A portion of each soup Pastrami Sandwich $19 Corned Beef Sandwich $19 Salami Sandwich $16 Ruggelach $4 Drink $2 Pastrami Combo Meal $30: Includes 1 soup medley, 1 Pastrami sandwich, 1 drink and 1 dessert Corned Beef Combo Meal $30: Includes 1 soup medley, 1 Corned Beef sandwich, 1 drink and 1 dessert Salami Combo Meal $27: Includes 1 soup medley, 1 Salami sandwich, 1 drink and 1 dessert Family dinner Includes 4 soups, 2 appetizers, 2 of each main, 4 drinks and 3 desserts How did you hear about this Bistro Night? Facebook/InstagramChabad WebsiteEmail/NewsletterThe Jewish Press PublicationFamily/FriendReturning CustomerChabad member I would like to sponsor a dinner for a family in our community ($50) Total $0.00 Payment* Credit Card Check or Cash Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration YearPlease make checks payable to Chabad of NebraskaBilling Address Street Address 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 I would like to receive news and updates from Chabad-Lubavitch of Nebraska by email. I understand that information I provide to Chabad-Lubavitch of Nebraska will be used according to its Privacy Policy and I can unsubscribe at any time. Submit Clear Form Should be Empty: This page uses TLS encryption to keep your data secure.
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