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Chai Club Donation form

Chai Club Donation form

 

 Chai Club Donation form.
...........................................

I want to make a Recurring Contribution of:
$18 $36 $54 $108 $180

$360

$1,800 $3,600 Other   


Personal Information
Title State
First Name Zip
Last Name Country
Address Phone
City This is my: Home address
Business address
 
Payment Information:
Card Type
Card Number
Expiration Date
CVV Security Code
Amount to be charged TODAY


Acknowledgement
Email Address
Reconfirm Email Address
Please acknowledge my gift by mail to the above street address.
You may acknowledge my gift to my email address 

Yes, please contact me to discuss additional giving opportunities.
 Yes, I want to stay involved with Chabad by receiving the Chabad
      eNewsletter. *We will not share your email information with outside parties

Please click submit only once.
Please wait a few seconds for acknowledgement online that your information was received.

 

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