Maryland Hillel Support Campaign

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1. Donation

Type*

One Time Donation

Monthly Donation

Annual Donation

Giving Levels*

Diamond Plus - $36,000

Diamond - $18,000

Platinum - $10,800

Gold - $5,400

Silver - $3,600

Bronze - $1,800

Friend of Hillel - Self Determined

Total Donation Amount*

Amount to be charged monthly*

A minimum of $18.00 is required.

Amount to be charged annually*

A minimum of $18.00 is required.

Total Donation

2. Your Information

Name*

First Last

Email*

Phone*

I am a(n)*

Alumni

Parent

Grandparent

Other

If selected "Other":

Graduation Year*

Child's Name*

Child's Graduation Year*

Grandchild's Name*

Grandchild's Graduation Year*

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

3. Payment

Please select your payment preference:*

Cash/Check- Sent to 7612 Mowatt Lane, College Park, MD 20740

Credit Card- Processed By Authorize.net

Donor Advised Fund/DAF

Stock Transfer

Other (please reach out to Leah Bregman)

Would you like to offset the 3% fee incurred by Maryland Hillel*

Yes

Additional 3%

Price: $0.00

Total

Credit Card*

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Expiration Date Month Year

Security Code Cardholder Name

Would you like Maryland Hillel to send you a self-addressed envelope?

Yes

Not Necessary

My gift is*

In Honor of Someone

In Memory of Someone

Not in Honor or in Memory of Someone

Name of Honoree*

Contact info (email or physical address) for person to be notified of in memory or in honor of donation:*

Keep my gift anonymous*

Yes

How would you like your name to appear for this donation*

My employer offers a matching gift program*

Yes

Name of Employer*

Employer's Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

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1. Donation

2. Your Information

3. Payment

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