JFCS/East Bay Donation Form

YES! I want to join the COMMUNITY FRIENDS PROGRAM and become a monthly contributor.

Please print this form and return it to us by fax or mail.
To fax: Fax your completed form to JFCS/East Bay at (510) 704-7494
Attn: Development Department
To mail: Mail your completed form to:
Development Department
Jewish Family & Children's Services of the East Bay
2484 Shattuck Ave., Suite 210
Berkeley, CA 94704

I am making a tax-deductible gift of:
$120 per month $60 per month
$30 per month $15 per month
$10 per month other (please indicate amount): _____ per month
Your Name(s): ________________________________________________
Address: ________________________________________________
City/State/Zip: ________________________________________________
Phone: ____________________ (if issues arise while processing your gift)
E-mail: ________________________________________________
  I wish to remain anonymous

Payment Options:
My check payable to JFCS/East Bay for my first month's gift is enclosed.
Please send me monthly reminders.
Signature: ______________________________________ Date: __________

Please charge my credit card the amount above each month.
Card type: MasterCard Visa

Card #______________________________________ Exp. Date_________

Name(s) on card___________________________________________________

Signature ________________________________________________________

I understand that my monthly giving can be increased, decreased, or suspended by calling JFCS/East Bay at (510) 704-7475, ext. 760.

For Tribute Gifts:
This gift is given:
in memory of ______________________________________
in honor of ______________________________________
on the occasion of ______________________________________
Please notify the following person(s) of this gift:
Name(s): _____________________________________________
Address: ______________________________________________
City/State/Zip: __________________________________________