Donation Form

Use this form to help The Friends of Jewish Dokshitsy save our history. I will help save our Jewish heritage with a gift of:

o $100 o $250 o $500 o $1000 o $ ____other

Name _________________________________________________________________

Address _______________________________________________________________

City ___________________ State ______ Zip/Post Code __________ Country_______

Phone: Home/work _______________________________ mobile ______________________ skype________________

E-mail:_______________________________________________

May we list you as a contributor? o Yes- Listing Preference ______________________ My donation is in memory / honor of ______________________________________ Send acknowledgment card to: __________ _____________________________________________________

Mail a check with this form to:

The Friends of Jewish Dokshitsy, Inc.

c/o Aaron Ginsburg

101 Chestnut St E1 DL

Foxboro, MA USA

*

All donations are exempt from United States Federal Income Tax under section 501(c)(3) of the Internal Revenue Code.

The Friends of Jewish Dokshitsy, Inc.

c/o Aaron Ginsburg

101 Chestnut St E1 DL

Foxbor, MA 02035 USA

Phone:617-640-0606 e-mail: info@jewishdokshitsy.org skype: aaron.ginsburg

homepage: www.jewishdokshitsy.org