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Online Donation Form

Type of Donation*
- Temple Donation
- Tree of Life
- Memorial Plaque
Temple Donation Amount
Please note donations are $18 minimum unless otherwise indicated. Thank you for your generosity and support.
Please choose a fund you would like to make your donation to:
Type of Tribute
- No Tribute
- In honor of
- In memory of
- On the occasion of
- In appreciation of
- For the speedy recovery of
- On the Yahrzeit of
Honoree/Occasion
Donor's Name
Donor's Address
Street Address Address Line 2 City State ZIP Code
Donor's Phone Number
Would you like this printed in the bulletin?
- Yes, please print this in the bulletin
Would you like to have an acknowledgement card sent?
- Yes
Send the Card to:
Acknowledgement Address
Street Address City State ZIP Code
Tree of Life Leaf Size
- Small Leaf - $250
- Large Leaf - $500
- Apple - $1,000
- Boulder - $5,000
Engrave the plaque as follows (i.e. In Honor of..., or In Memory Of...):
NO CHANGES TO TEXT WILL BE ALLOWED ONCE ORDER IS SENT TO FACTORY
Memorial Plaques Quantity
Price: $500.00
Information for Memorial Plaque(s)
Please allow 8 weeks production time.
Name of Deceased Date of Death (English) Before or After Sunset?
Payment Information
Payment Method*
- Pay by credit card (processed by PayPal; no PayPal account required)
- Pay by check
Please make your check payable to the synagogue and mail it to the synagogue office with a copy of the email receipt you will receive upon submission.
Please note that upon submission, you will be taken to PayPal's website in order to enter your credit card information.
Would you like to add an amount to cover the credit card convenience fee?
- Yes - let me add a 2.5% contribution
Additional contribution to cover the credit card convenience fee
Price: $0.00
Total
$0.00
Billing Information
Billing Name*
First Last
Billing Address*
Street Address City State ZIP Code
Billing Phone*
Billing Email*

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Name of Deceased	Date of Death (English)	Before or After Sunset?

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