North Louisiana Jewish Federation

Name ________________________________________________________________________
 
Address ______________________________________________________________________
 
Email address _________________________________________________________________
 
Home phone number ____________________________________________________________
 
Business phone number _________________________________________________________
 
Cell phone number _____________________________________________________________
 
Amount of donation $__________
 
Of the above amount, specify portion that should go towards:
 
$__________ Regular Campaign
 
$ __________Endowment Campaign
 
Other designations (optional):
 
Donation is in Memory of ________________________________________________________
 
Donation is in Honor of __________________________________________________________
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