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Chanukah Donation Form (1)

Product Name

Option

to buy a doll, train set, or electronic game to brighten the life of a hospitalized child

to provide Chanukah treats for an entire children’s ward in an Israeli hospital

to give four hospitalized children a menorah, dreidel, and Chanukah gift

to give cozy nightgowns or pajamas to 20 institutionalized kids

any amount brings joy to these precious kids just when they need it most

Total

שֵׁם(חובה)

ראשון אחרון

אימייל

Credit Card

American Express

Discover

MasterCard

Visa

מספר כרטיס

תאריך תפוגה

קוד אבטחה שם בעל הכרטיס