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Amount
$1,000
$500
$360
$180
$100
$50
$36
$18
Other
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Purpose
Purpose
Donation
Kiddush
Event
Aliya
Calendar
Passover
Israel Emergency Fund
Purim Project
Please charge this amount for the next 12 months
Contact Information
Title
Title
Mr.
Ms.
Mrs.
Dr.
Dr. & Mrs.
Mr. & Mrs.
Rabbi
Rabbi & Mrs.
First Name
*
Last Name
*
Address
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City
State
Zip Code
Phone
Email
Credit Card Information
Card Type
Card Type
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*
Card Number
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Expiration
Month
1 - January
2 - February
3 - March
4 - April
5 - May
6 - June
7 - July
8 - August
9 - September
10 - October
11 - November
12 - December
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Year
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
*
Card Code
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Name
Address
Zip Code
Other Information
Please contact me to discuss additional giving opportunities
Note
In honor of
In memory of
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