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Donation & Registration Form

Donation & Registration Form

Secure On-Line Donation Form
North Suburban Lubavitch Chabad is a 501(c)3 nonprofit organization. All grants and charitable contributions are tax-deductible. We sincerely appreciate your generosity!

A little bit of light dispels a lot of darkness.
Rabbi Schneur Zalman of Liadi

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SECURE CREDIT CARD DONATION FORM

Please select DONATION TYPE from menu:

In Memory of: Make a donation in memory of a deceased family member or friend.
In Honor of: Make a donation in honor of someone who inspired you.

Name:

 


First Name
Last Name
Street Address
City
State
Zip Code
Email
Phone

Credit Card
Credit Card # No Dashes
Expires (MM/YYYY)
CVV Code (?)
Amount $


I would also like to contribute this amount on the following recurring scheduleYes
Frequency
Duration
Amount

Send acknowledgement to - If you want an acknowledgement of your donation to be sent to the honoree or their family, please provide the following information. Please provide either a street address or an email address. Please use the comments section below to provide additional information as to what the acknowledgement shall refer.

Name

Address

City

Sate Zip

email

Comments/Follow Up Instructions

 

 

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