*
Amount:
I would like to cover processing fees (3%) to ensure that WTA receives more of my contribution.
.03
Full Name(s)
*
Exactly as you would like them to appear
Email
*
example@example.com
Affiliation
*
Parent
Grandparent
Faculty/Staff
Supporter
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Will you be attending the dinner on February 23?
*
Yes
No
Number of Dinner Reservations
*
Please list the names of those attending
*
In Honor of
Raquel & Judah Sosnick
Morah Talia Michaeli
Nate Polachek
Other
Bracha (Message)
Include a photo with your Bracha
Browse Files
Cancel
of
How would you like to pay?
*
Credit Card/Apple Pay
Check
Other
TOTAL
Total Donation
prev
next
( X )
USD
Submit
Should be Empty: