Donation

* Mandatory fields
 

Contact Data

*First name(s)
Your first name
*Last name
Your last name
*Email
Your email address
*Phone primary
Your primary phone number
*Phone unlisted
Is your phone number unlisted?
*Mailing address1
Your mailing address
Mailing address2
(Apartment number, etc.)
*City
Your city
*ZIP / Postal Code
Your postal code / ZIP code
*Donation date
...
Date donation made.
*Amount ($USD)
Enter only the numeric value of the total dollar amount of donation. Do not include the "$" sign; i.e. 25, 50, 100.
*Donation fund
For multiple donations; enter the total amount of donation and in the comment box specify the specific fund and amount you which to donate too. Example: Total amount $40, Cultural Center $20 & Homeland $20.
Comment
Used by donator to make a comment regarding his/her donation.
 
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