Printable Mail Form

Thank you for your interest in supporting Chabad Lubavitch of the Maritimes! Your support makes you an important partner in our vital task of strengthening Jewish identity, unity and commitment.

Please make your check payable to Chabad Lubavitch of the Maritimes and send to:

   Chabad of the Maritimes  
   1171 Waterloo Street
   Halifax, NS  B3H 3L6

If you'd like to give us more specific information or would like to give us your credit card information by mail, please print and fill out the form below and send it to the above address.

Thank you very much!

Rabbi Mendel Feldman 

Executive Director, Chabad Lubavitch of the Maritimes

Payment Method:

   Enclosed is my check
   Please charge my credit card account using the information provided below.

I'm happy to make a tax-deductible contribution to Chabad Lubavitch of the Maritimes for:  

      $18 Chai             $36 Double Chai     $54 Triple Chai    $72 Associate  

     $150 Friend      $180 Sponsor         $360 Patron          $500 Benefactor  
     

 $1000 Partner    $1800 Chai Partner   $2500 Partner  Other____________


  Visa    

Card Number:  ________-_________-_________-_________   

Exp. Date (mm/yy) ______/______

 Please contact me to set up a meeting
 
Your First & Last Name: ______________________________________
Address: ______________________________________
  ______________________________________
City, Province, Postal Code: ______________________________________
Country
(if outside Canada):		 ______________________________________
E-Mail address: ______________________________________
Daytime Phone: (____)______________________
Evening Phone: (____)______________________

If you would you like this gift to be a tribute, please answer the following:

SELECT ONE.

This gift is...
   In Memory of
   In Honor of

To Mark a Special Occasion: 
   Birthday
   Bar/Bat Mitzvah
   Anniversary
   Other _____________


Honoree's Name:

_____________________________________
To have notification card(s) sent, please complete the following.

I would like a notification card without the gift amount mailed to:

Name: ______________________________________
Address: ______________________________________
  ______________________________________
City, Province, Postal Code: ______________________________________
Country (if outside Canada): ______________________________________
From (Your name as you would like it to appear on the card): ______________________________________

I would like a second notification card without the gift amount mailed to:

Name: ______________________________________
Address: ______________________________________
  ______________________________________
City, Province, Postal Code: ______________________________________
Country (if outside Canada): ______________________________________
From (Your name as you would like it to appear on the card): ______________________________________