Mezuzah Campaign - Chabad Jewish Centre

Chabad of Kirkland Mezuzah Order form
Select all that apply

I would like to receive a mezuzah, compliments of the Mezuzah Campaign (limit of one per household) I would like to purchase mezuzah(s) - $50.00 each I would like to have my mezuzah(s) inspected - $10.00 each
How many Mezuzahs for purchase*
How many Mezuzhas for check*
Total

$0.00
We will be in touch with you to schedule a time to affix your mezuzah.
Full Name

First Name Last Name
E-mail
Phone Number

Area Code Phone Number

Address

When is a good time to reach you?

Hour Minutes
When is a good time to come affix the Mezuzah

(masked and following all Covid 19 regulations)
Comments, Questions etc

Payment

Credit Card E-transfer or Check

This page uses TLS encryption to keep your data secure.