Haftarot Scroll Project Commitment Form - Form

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Choose How to Inscribe Your Name in the Haftarot Scroll
Fill out the secure form below to participate and support the Haftarot Scroll Project.

* First Name

* Last Name

* Address, Line 1

Address, Line 2

* City

* State

* ZIP Code

Phone

* E-mail Address

Haftarot Scroll Project Contribution Levels:

Special Sponsorship Opportunities:

From the dropdown menu above,
select your 1st Choice for the Haftarah portion.

From the dropdown menu above,
select your 2nd Choice for the Haftarah portion.

Haftarot Scroll Project Dedication:

*For donors selecting a full Haftarah to sponsor ($10,000), please complete the box below:

Dedication: up to six lines total, no more than 30 characters. Suggested format:

Line 1 - Donor(s) Names

Additional Lines - other inscription of your choice (i.e. in memory of or in honor of)

Please check total before submitting this form.

Credit Card Convenience Fee: Please consider adding to your payment the amount to cover the Credit Card Convenience Fee to help offset processing costs. Please note: if you pay via E-check, there is no convenience fee.

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