Chabad of Peabody Kiddush Sponsorship form

I would like to sponsor a Kiddush. Please put me down for (date) .
This sponsorship is in honor or in memory of .
Please charge me the $180 sponsorship fee.
I would like to make a more elaborate Kiddush or would like to add to the regular contribution. Please charge me an addtional $ US

Please charge my Credit Card

* Denotes required field

First Name*
Last Name*
Address Line 1*
Address Line 2
Post Code*
This is my home business address.

Card Type
Card Number

Expiration Date

3 or 4 digit security number

Email Address
Reconfirm Email Address

Please acknowledge my gift by mail to the above street address.

Please click submit only once.
Please wait a few seconds for acknowledgement online that your information was received. We will send you a receipt once your donation has been processed. If you have problems with this form please notify us by clicking here.

For additional donation and sponsorship opportunities please click here