Printable Mail Form

Thank you for your interest in supporting Chabad at Chestnut Hill! Your support makes you an important partner in our vital task of strengthening Jewish identity, unity and commitment.

Please make out your check to Chabad at Chestnut Hill and send it to:

Chabad at Chestnut Hill 
163 Bellingham Road 
Chestnut Hill, MA 02467

If you'd like to give us more specific information or would like to give us your credit card information by mail, please print and fill out the form below and send it to the same address.

Thank you very much!

Rabbi Mendy Uminer
Director, Chabad at Chestnut Hill

Payment Method:

   Enclosed is my check
   Please charge my credit or debit card account using the information provided below.

I'm happy to make a tax-deductible contribution to Chabad at Chestnut Hill, in the amount of:   

 $18,000 - Double Chai Supporter  $10,000 Chai Supporter  $5,400 - Supporter
 $3,600 - Founder  $1,800 - Partner  $1000 - Contributor
 $540 - Friend  $360  $180
 $100  $54 Other: $  


 


 

 

 MasterCard    VISA     American Express 

Card Number:  _______-________-________-________ Exp. (mm/yy) ____/____

 Please contact me to set up a meeting
 
Your First & Last Name: ______________________________________
Address: ______________________________________
  ______________________________________
City, State, Zip: ______________________________________
Country
(if outside U.S.A.):		 ______________________________________
E-Mail address: ______________________________________
Daytime Phone: (____)______________________
Evening Phone: (____)______________________

If you would you like this gift to be a tribute, please answer the following:

SELECT ONE.

This gift is...
   In Memory of
   In Honor of

To Mark a Special Occasion: 
   Birthday
   Bar/Bat Mitzvah
   Anniversary
   Other _____________


Honoree's Name:

_____________________________________
To have notification card(s) sent, please complete the following.

I would like a notification card without the gift amount mailed to:

Name: ______________________________________
Address: ______________________________________
  ______________________________________
City, State, Zip: ______________________________________
Country (if outside U.S.A.): ______________________________________
From (Your name as you would like it to appear on the card): ______________________________________

I would like a second notification card without the gift amount mailed to:

Name: ______________________________________
Address: ______________________________________
  ______________________________________
City, State, Zip: ______________________________________
Country (if outside U.S.A.): ______________________________________
From (Your name as you would like it to appear on the card): ______________________________________