Online Payment of Rental Fees

Please Note: DO NOT USE THIS FORM FOR FACILITY OR ROOM RESERVATIONS.
Event scheduling and reservations MUST be made through the BIJ office at 415.586.8833 x25

Use this form to pay for reservations already scheduled through the BIJ office.

(Security Deposits must be paid by check to the BIJ office.)

* Date of Event

* Name of Event

* Which Room(s) Are You Renting?

* Event Start Time

* Event Finish Time (Charges will be incurred if your event runs over allotted time.)

* Membership

	BIJ Member
	Or Shalom Member
	Not a Member

* Full Name

* Street Address (Address information required for payment verification.)

* City, State, and Zipcode

* Phone Number

* Payment Description (e.g., "payment for Social Hall for March17, 2016 event")

* Payment Amount $

Would you like to make recurring payments?

Account Details

Enter your name and e-mail address for your confirmation:

*E-mail

*First Name

*Last Name

Payment Information

Account

Online Fee:

Credit Card

Name on Card

Card Type

Card Number

Expiration Date

Card Verification Number

Address Line 1

City

State/Province

Zip

Comments

Would you like to increase your donation by 3% to cover credit card fees. No fee for electronic checking

Total:

Online Payment of Rental Fees