Payment for Services Form

Full Name (as it appears on your credit card)*

First NameLast Name

Phone Number*

Area CodePhone Number

E-mail*

Client Name:*

First NameLast Name

This payment is for: *

Description of Payment beyond Dropdown:

Payment Amount:*

USD

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Jewish Family Services Privacy Policy:

JFS only collects contact information (name, address, number, email) and donation amount. This information is for JFS use and is NOT sold, traded, or given to any other organization or entity.

Refund Policy:

If for any reason you need to change or refund your payment or donation, please call us at (734) 769-0209 and ask for the Development Associate. All refunds will be taken into consideration.

Delivery Policy:

You will receive an email shortly with confirmation of donation/payment. If you do not see the email, please check your Junk/Spam Mail folder.
For all donors: A thank you letter will be sent to you in the mail with donation amount, which can be used for tax purposes.

Enter the message as it's shown*