Donation Form

Donation Amount*

Please choose a fund you would like to make your donation to:*

If you wish us to direct your gift to one of the dedicated funds, please select the fund to which fund you wish us to direct your gift from the pulldown list below. For an explanation of each of the funds, click here.

Type of Tribute*

Description of Tribute (e.g., an event or a person's name)

Would you like to have an acknowledgement card sent?

Yes

Send the Card to:

Acknowledgement Address

Street Address City State ZIP Code

Payment Information

Payment Method*

Pay by credit card
Pay by check

Please make your check payable to the synagogue and mail it to the following address:

Adat Shalom Reconstructionist Congregation
P.O. Box 418
Montvale, NJ 07645

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

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Billing Information

Billing Name*

First Last

Billing Address

Street Address City State ZIP Code

Billing Phone

Billing Email*

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Donation Form

Payment Information

Billing Information

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