Donating by check or bank draft
Please fill in your personal information and then press your browser's "Print" button to print the form on your printer. The information in this page will not be sent over the Internet. Please send us the form together with your check or bank draft at the address listed below or to one of our overseas transfer agents listed here. Thank-you!
Personal information:
| Name(Last/First): | |
| Street Address: | |
| City: | State/Province: |
| Country: | Postal Code: |
| Phone: | Fax: |
| Email: | |
Signature: |
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I am attaching a donation of:
| $5000 | $1000 | $250 | $54 | $18 |
Other (indicate currency of other than US $) | ||||
I want to establish a Perpetual Named Loan Fund:
in honor memory of: OR
with the name Fund.
Total accumulated donations must reach a minimum of $5,000 (or equivalent in any currency) to create such a fund.
*All smaller donations intended toward this goal will be attributed to the General Loan Fund until the amount of $5000, at which time the Fund will be named.
I want to donate my Israel Bonds:
what does this mean?I am donating the attached Israel Bonds to IFLA.
Please send me more information on the IFLA.
Please feel free to put additional comments on the back of this page.Please use your web browser's print button to print this form and send it to us at:
| The Israel Free Loan Association 29 Rivka Street Jerusalem, Israel 93461 |