Donation Form 1 Section 12 Section 2 Donation InformationName* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Business NameOptionalNew TorahNew TorahNew Torah Add to cart in Honor ofDonation AmountDonation*$18$36$50$101$360$500$750$1,000$1,800$3,600$5,000$10,000$18,000Please Charge Me*MONTHLYYEARLYONE TIME DONATION The Atid Fund is pleased to publish a Book of Appreciation for its 1st Annual Gala Dinner. The purchase of an ad in this journal is the perfect opportunity to express your gratitude and appreciation to our guests. I shall attend the 1st Annual Gal Dinner. Please reserve seatsPlease enter a value greater than or equal to 1.Seats at $180 per person.Couples reservation. Please reserve seatsPlease enter a value greater than or equal to 1.Seats at $360 per couple.I cannot attend the dinner, but I am pleased to contribute I would like to participate in the Journal. Name First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Mode of Payment*Check EnclosedPlease Bill MeMakes Checks Payable to: Atid Fund Reference Memo as "Dinner" Mail To: 7355 194 street, Fresh Meadows NY 11366Bill my*DISCOVER CardMasterCardVISA CardAMERICAN EXPRESS CardCredit Card No*Expiration Date*Zip*Signature Business Card Quarter Page Half Page Full Page (All donations are tax-deductible) Your IP "35.208.190.159" is recorded for security purpose. Δ This iframe contains the logic required to handle AJAX powered Gravity Forms.
Atid
August 26th, 2015 View Profile