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Online Donation

Use this form to make an online donation.

Donor information

Campaign

NYConnect Fund

First Name*

Last Name*

Address*

City*

State*

Zip*

Country*

Phone*

E-mail*

Temple Israel Member?*

yes
no

Full Name*

Hebrew Name

Put on list by*

Relationship

Select Discretionary Fund*

*

Name/Anniversary*

In memory of*

*

*

Name/Anniversary*

Name/Anniversary*

In memory of (please separate names with a comma)*

*

Name/Anniversary*

*

Name/Anniversary*

*

Name/Anniversary*

*

Name/Anniversary*

*

Name/Anniversary*

*

Name/Anniversary*

*

Name/Anniversary*

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Name/Anniversary*

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Name/Anniversary*

*

Name/Anniversary*

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Name/Anniversary*

*

Name/Anniversary*

*

Name/Anniversary*

*

Name/Anniversary*

*

Name/Anniversary*

Same entries as last year?*

yes
no

Comment

Donation Information

Amount

$

Payment method

Paypal

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card type*

Card Holder Name*

$0.00

$

$0.00

$

$0.00

$

$0.00

$

$500.00 [ Small Leaf ] $1,000.00 [ Large Leaf ]

$

$0.00

$

$0.00

$

$5,000.00 [ Seat Plaque ]

$

$36.00 [ Prayerbook ] $72.00 [ Chumash ]

$

$1,800.00 [ Memorial Plaque ]

$

$1,800.00 [ Bar/Bat Mitzvah Torah Portion Dedication ]

$

$200.00 [ Friday Tot Kabbalat Shabbat in the Park ] $360.00 [ Tot Shabbat and Holidays ] $720.00 [ Tot Rosh Hashanah and Yom Kippur ]

$

$0.00

$

$0.00

$

$0.00

$

$0.00

$

$0.00

$

$0.00

$

$0.00

$

$0.00

$

$0.00

$

$0.00

$

$72.00

$

$0.00

$

$0.00

$

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Contact Info

admin@templeisraelnyc.org

Temple Israel of the City of New York
112 E. 75th Street
New York, NY 10021
P: 212-249-5000
F: 212-861-9092

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