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Donation form:
Check and mailing address for UK donors: (No credit cards) Registered
Charity 1091331
Euro ChaiSouthAfrica
C/O Harley Kagan / Richard Jaffee
43 Middleway, Hampstead Garden Suburb, London NW116SH
eurochai@yahoo.com
YES- I would like to help by making a meaningful one-time donation of $________________ OR - I would like to make a [ ] Monthly or [ ] Quarterly donation of $ ___ (cc only)
[ ] Indefinite [ ] 1 year [ ] other
Name: ____________________________________________________ Address: __________________________________________________ City: : ____________________ Province:_________________________Postal Code:_____________ Country:_________________________________________Phone: (______)____________________ Email: ____________________________________________________
Signature:_______________________
I would like to donate my contribution to:
[ ] Glendale Home for the Jewish Handicapped, Cape Town,
[ ] Oranjia Orphanage, Cape Town
[ ] Highlands House, Jewish Aged Home, Cape Town
[ ] Beth Shalom, Jewish Aged Home, Durban
[ ] Jewel House, Home for the Jewish Handicapped, Durban
[ ] Arcadia Orphanage, Johannesburg
[ ] Our Parents Home, Jewish Aged Home, Johannesburg
[ ] Sandringham Gardens, Jewish Aged Home, Johannesburg
[ ] Society for the Jewish Handicapped, (Selwyn Segal) Johannesburg
[ ] Jaffa House, Jewish Aged Home, Pretoria
TRIBUTES/ YAHRZEITS USA and Canada (Minimum $36 per
tribute) and Australia ( minimum $54) only. A lovely tribute card will be
sent to those you are honoring.
This donation is in [ ] Honor, [ ] Memory of
Name
Address
City, State, Zip, Country Email
On the occasion of:
From:
Thank you for making a difference.
If you would like to join one of our international liaison committees
please email eurochai@yahoo.com or
chaisa@jcfsandiego.org
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