Chai Club Form I want to make a contribution of $36 $54 $108 $180 $360 $720 $1,800 $3,600 other $ Recurring Donation Your recurring gift will create an ongoing relationship between you and the Chabad community you are supporting and will join you with the "Chai Circle." Please charge the above amount to my credit card on the first day of each month for the duration of one year: Optional In Memory of Make a donation in memory of a deceased family member or friend. In Honor of Make a donation in honor of someone who has inspired you. * Denotes required field Title* Chaplain Dr. Dr. & Mrs. Drs. Mr. Mrs. Ms. Mr. & Mrs. Rabbi Rabbi & Mrs. The Honorable First Name* Last Name* Address Line 1* Address Line 2 City* State Post Code* Country Phone This is my home business address. Card Type Please Select Visa MasterCard American Express Discover NO CC However Please Send and Invoice Amount to be charged Card Number Expiration Date Month 01 02 03 04 05 06 07 08 09 10 11 12 Year 2018 2019 CVV 3 digits on back of card Acknowledgement Email Address Reconfirm Email Address You may acknowledge my gift to my email address Please acknowledge my gift by mail to the above street address. Please contact me to discuss additional giving opportunities. Please click submit only once. Please wait a few seconds for acknowledgement online that your information was received. We will send you a receipt once your donation has been processed. This page uses 128 bit SSL encryption to keep your data secure.