Name __________________________________________________
Home Address ___________________________________________
City ________________________________ State ____ Zip __________
Home Phone ________________ Cell Phone _______________________
Email ______________________________ Donation Amount $_____________
This gift is in Honor/Memory/Celebration (please circle) of
_____________________________________________
For a contribution to the General Fund, please check here ______
To partially sponsor a Kiddish Luncheon (minimum $180), please check here _______
To partially sponsor a weekly clergy for Shabbat Services (min $180), please check here ______
Please send acknowledgment card to:
_______________________________________________
_______________________________________________
_______________________________________________
GIFTS ARE TAX-DEDUCTIBLE TO THE EXTENT ALLOWED BY LAW.