Sponsor Kiddush Form

CJC of Mission Viejo Kiddush Sponsorship form. 
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I would like to sponsor a Kiddush.  Please put me down for (date)  .   
This sponsorship is in honor or in memory of . 

Please Bill me the $260 sponsorship fee for a basic kiddush.
I would like to make a more elaborate Kiddush or would like to add to the regular contribution.  Please charge me

Fish Kiddush $375

Meat Kiddush $450

Please charge my Credit Card 

* Denotes required field

* Denotes required field Title*    

 First Name*

Last Name*  

Address Line 1*

Address Line 2

City* State

Post Code* Country Phone This is my  home  business address.
 

   
Please charge my Credit Card

Card Type  Visa Master Card Amex

Number

Expiration Date 01 02 03 04 05 06 07 08 09 10 11 12 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

3 or 4 digit security number

  

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 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. If you have problems with this form please notify us by clicking here.