First Name * Last Name * Enter the name of the Card owner Address * Address Line 2 City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip * Phone Format: 1-234-567-8910 or (234) 567-8910. Add extension as needed. Email * This is to notify you of your donation by email I/we wish to make a donation of: $500 $1,800 $2,000 $3,600 $5,400 $10,000 $25,000 $50,000 I/we would like to make a total pledge of $ .00 Pledge will be paid over - None -1 year2 years3 years4 years5 years (Pledges may be paid over a maximum of 5 years). How should your gift be used? Our gift is unrestricted. Please use it where it is most needed. Our gift is restricted for the use indicated below... Endowment (specify / amount) Capital Expenditures (specify / amount) Other (specify / amount) I/we are making this gift in honor of I/we are making this gift in memory of I/we would like our gift to be anonymous NoYes Would you like this to be an anonymous gift? Selecting this option will prevent your name from being published in reference to this gift. I/we have made arrangements for a planned gift to Congregation Shalom. NoYes I/we would like to discuss planned giving options with Congregation Shalom. NoYes Comments Credit Card Information E-mail * Card type Visa Mastercard Card number * Security code 01- January02- February03- March04- April05- May06- June07- July08- August09- September10- October11- November12- December 2018201920202021202220232024202520262027 Contact Linda Holifield at 414 352-9288 or at [email protected] with questions. By clicking the "Make Donation" button below you are agreeing to our Terms and Conditions. Please review all fields above as there is no "review" step and your card will be charged immediately. Do not click more than once or you may be double charged!