MONTHLY

Monthly Pushke & Online Giving

First Name

Last Name

Cell Phone

Email

Choose Your Monthly Pushka Donation

High Five - $5Ten Yad - $10Chai Sponsor - $18Koach - $28Nediv Lev - $32Chamushim - $50Meah Shearim - $100

* Authorization

Authorization

I authorize OZ to charge my account each month until if I decide to cancel

Total Monthly Subscription

To change or cancel your subscription

please contact the Synagogue office

Mon, June 27 2022 28 Sivan 5782

118 West 95th Street, New York, NY, 10025

Telephone: 212.749.5150 Fax: 212.663.3635