Donation Form


We at the JDA regard our mission as a Mitzvah (good deed). We thank you for your willingness to be a part of this important work and are grateful for your generosity.

. “…From Every Person Whose Heart Inspires Him To Generosity, You Shall Take My Offering” (Exodus, chap. 25)


Friend $54
Sponsor $72
Supporter $118
Dedication $180
Patron $360 (option for side bar space on our website for 1 month)
Dedicate a page on our website with a banner $500 (for 1 month)
Other      


PAYMENT OPTIONS BELOW
Your donation is tax deductible

As a token of our gratitude we are happy to provide the following:

Donations of $180 and higher will receive a free copy of EnLITEned Kosher Cooking

Name:

Address:
 Street
 City
 State
 Country
 Zip












Phone:Fax:
Email:  




Date of Birth:

We do encourage you to become a registered member of the JDA. There is no membership fee but we would appreciate it if you filled out an application form, sharing diabetes related information with us.

As a member we will be happy to supply you with up to date information on all diabetes related issues in general, and about issues that are typical and relevant to the Jewish community in particular.
Do you wish to receive updates and information via e-mail?
Yes
No

PAYMENT OPTIONS:

Please make checks or money orders payable to Jewish Diabetes Association. Your donation can be mailed to our Brooklyn office and/or Israel office.

USA office: 2711 Avenue J • Brooklyn, NY 11210
Israel office: P.O. Box # 43195, Har-Nof, Jerusalem 91431


Check
Money Order
Visa
MasterCard
American Express
Discover

Print name
(as it appears on the card)
Card #
Exp Date
Security Number
(And 3-4 digit ID code number on the back of the card)









Should you choose to dedicate your donation in memory of a loved one or in honor of someone dear to you, we will gladly send a certificate to commemorate the donation, with your receipt.