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Donation Form - Single Step

* required information
Donation
Select Gift Frequency
I would like to make a one-time gift for the following amount:
:* $
I would like to make a recurring gift.
Gift Amount* # of Payments Payment Frequency Total Gift Amount
$ X = $
NOTE: This transaction will count as the first payment toward your total gift amount.
Donor Information
First Name:*
Last Name:*
Address Line 1:*
Address Line 2:
City:*
State:*
Province:
ZIP/Postal Code:*
Country:*
Phone:
Email:*
I am a Hadassah Member:
Member ID #:
If you know of a local Hadassah unit you wish to be affiliated with, please list it here:
Payment Information
:*
:*
Credit Card Type:*
                  
Credit Card Expiration:*
Billing Information
If the billing information is the same as the contact information check this box.
If not please fill out the information below:
:*
:
:*
State:
:
:*
Country:*
Charitable deductions are allowed to the extent provided by law. Please consult your tax advisor.

Hadassah acknowledges your recommendation, however, in accordance with U.S. tax law requirements regarding deductibility of contributions, Hadassah shall have full dominion, control and discretion over this gift.
Type the characters you see in the picture below:*
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