Jewish Records Indexing - Poland
Contribution Form
For security reasons, JRI-Poland does not accept
credit card contributions over the Internet.
Please fax, mail or telephone your contributions to:
Jewish Records Indexing – Poland
c/o Sheila Salo, Treasurer
5607 Greenleaf Rd.
Cheverly, MD 20785
Telephone: 301-341-1261
Fax: 1-810-592-1768 (24 hours)
If your employer has a matching gift program,
please consider matching your JRI - Poland donation through that program.
Please complete ALL sections of this form.
Visa [ ] MasterCard [ ] (Visa or MasterCard only, please)
Name as it appears on Credit Card _________________________________
Signature ______________________________________
Credit Card Number________________________________
Expiration Date_________________________
Contribution in US$_______________
Please indicate the specific JRI-Poland project to which your
contribution should be directed. Otherwise enter "general indexing"
___________________________________________
Billing Address of Credit Card
Street and House Number______________________________
Apartment or Flat Number_____________________________
City_________________________________________________
State/Province_______________________________________
Zip/Postal Code______________________________________
Country______________________________________________
Email Address________________________________________
Home Phone___________________________________________
Home Address (if different from Billing Address above)
Street and House Number______________________________
Apartment or Flat Number_____________________________
City_________________________________________________
State/Province_______________________________________
Zip/Postal Code______________________________________
Country______________________________________________
Jewish Records Indexing – Poland, Inc. is a non-profit 501(c)(3) organization.
Contributions to Jewish Records Indexing – Poland are tax-deductible in the
U.S. and Canada to the extent permitted by law.
