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Contact Information |
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First Name
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Last Name
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Address
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City, State & Zip
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E-mail Address |
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Phone |
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Donation/Sponsorship
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2 Seder Nights For A Family of 4
($200) |
I Will Bring A Food Donation
Suggested Food Item List and Kosher Symbols Below
All Foods Must Be Kosher For Pesach |
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1 Seder Night For A Family of 4
OR
2 Seder Nights For A Family of 2
($100) |
*Matzah
*Matza Meal
*Chicken
*Gefilte Fish
*Boxed Soup
*Apple Sauce
*Passover Crackers
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*Wine/Grape Juice
*Jam
*Macaroons/Cookies
*Canned Tuna
*Canned Vegetable
*Juice
*Tea
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1 Seder Nights For A Family of 2
($50) |
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1 Seder Dinner For An Individual
($25) |
Click Here For Other Kosher Symbols
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Donate (Other) |
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Name on Card |
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Total Payment Amount |
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CC Type |
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CC Number |
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Exp. Date |
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CCV# (on back of card) |
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Comments (Optional) |
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If this donation is in honor/memory of someone, please fill in the name and address to which you would like a notification card mailed along with a message to the recipient below: |
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Problems with this form?
Please call Misia at at (414) 228-8372 or e-mail [email protected]. |
