(5031) Miriam Leikind Library Fund

Used to expand our current important educational programs for the religious school students and parents (also stamps).

* I would like to make the following donation: $

My contribution is in recognition of the following occasion

In Honor of

In Memory of

By:

(your acknowledgement will be printed exactly as it is typed here)

Please Notify Name

Street Address

City State Zip

Comments or further instructions:

Please list preferred date choices, if any.

Thank You for Your Contribution!

*E-mail

*First Name

*Last Name

Account

Name on Card

Card Type

Card Number

Expiration Date

Card Verification Number

Address Line 1

City

State/Province

Zip

Comments

Increase the payment amount by 3% to cover credit card fees (No fee for Checking)

Total: