Beth Shalom Donation Form

Beth Shalom
5713 Yates Mill Pond Rd
Raleigh, NC 27606
919-858-7777

Beth Shalom Donation Form

"No act of kindness, no matter how small, is ever wasted."
~ Aesop

Thank you for your donation to Beth Shalom. Your generosity helps us continue to provide a community for many youth and adults who rely on us for engagement, support, and nurturing of their Jewish identity. You may choose to make a donation to honor a special person and/or occasion, to congratulate or thank someone, or to remember a loved one or friend.

This form provides you with two options for getting your information and donation to us. First, after entering your information, you may print your completed form and mail it with a check to Beth Shalom. Or, you may complete this form, submit it, and pay electronically through PayPal with a credit/debit card.

If you have questions, please email the Beth Shalom office.

We, at Beth Shalom, extend our heartfelt thanks and wish you and yours much joy, health, and happiness!

Name(s) of Donor(s)*

Address of Donor(s)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary E-mail*

example@example.com

Preferred Phone*

Please Enter your Donation*

e.g., 108

Select the fund to which to allocate the donation*

Are you printing this form and mailing your donation or will you be paying electronically after submitting your information?*

Donation by MailElectronic Donation

Processing Fee

Beth Shalom is charged a small processing fee. Would you like to cover this cost?*

YesNo

Total Donation

Would you like your donation to be anonymous?*

YesNo

If you would like to remember or honor someone or commemorate an event, please indicate below:

Name of honoree and occasion if applicable (e.g., congratulations to Mary Smith on her Bat Mitzvah). You may also indicate the relation of the honoree to a Beth Shalom member (e.g., in memory of Jane Doe, mother of John Doe).

Would you like a tribute card sent?

YesNo

Name of person to receive the tribute card

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Comments or additional information

To pay by credit/debit card, please complete the information below. Please note: when paying by debit or credit card, you must type the name of the cardholder in the top two unlabeled blank spaces (see picture below). Then enter the credit card information. If you have any questions, please email the office.

To print this form and mail it with your donation check, please click on the "Print" button below (do not click on the Submit button). Make checks payable to Beth Shalom and mail to: 5713 Yates Mill Pond Rd, Raleigh, NC 27606. To submit this form and pay electronically, please click on the "Submit" button below.

Donation Amount

USDDonation to Beth Shalom

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.