Siach Yitzchok
Secure Payment Form
Donation Summary
Donation Amount
*
-- Select --
$10,000
$3,600 - Month of Learning
$1,800
$1,000 - Week of Learning
$720
$360 - Day of Learning
$180
$100
$72
$36
$18
Other Amount
Donation Frequency
*
-- Select --
One Time Donation
Monthly Recurring Donation
Split Donation
Number of Months to charge FULL amount listed above
No End Date
Payment for:
*
-- Select Payment Allocation --
New Donation
Lunch Program
Rabbeim Fund
Bike-A-Thon
Building Dedication
Dinner Pledge
Minivan Raffle
Grandparents Club
Kapporos
Keren Hachesed
Tuition
Annual Oil Campaign
Summer Campaign
Other
In Honor Of
None
This donation is in honor / memory of:
Card Information
Cardholder Name
Card number
*
Exp date MMYY
*
CVV
*
Billing Information
First Name
*
Last Name
*
Address
*
Address 2
City
*
State
*
Zip
*
Phone
Email address
*
*
Required Fields
Payments Processed by: Paytek Payment Solutions – www.paytek.net
© Copyright 2022 Paytek Payment Solutions