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Special Occasion Donation Form

The following form is provided for your convenience to make special occasion donations in memory of someone, to recognize someone, or for other special occasions.

Enclosed is my tax-deductible gift of to the following Federation sponsored activitiy(ies):
Federation General Fund
Local Youth Camper and Conference Scholarships
Jewish Family Services (Lane County)
Jewish Federations of North America (Formerly UJA)
In honor of:
In recognition of:
In memory of:

(name)
My gift is in recognition of:
Speedy recovery
Wedding
Anniversary		 Birthday
Birth of:
Other:
Contributor's Name:
Address:
City:
 State:  Zip Code:
Telephone:
E-mail:
Please send an acknowledgement card to:
Name:
Address:
City:
 State:  Zip Code:
E-mail Address:
Your thoughtful gift will be acknowledged with an appropriate card in accordance with your wishes. The amount will not be disclosed.

Mark only if you do not want this gift acknowledged in the Federation Newsletter
Additional comments:
1. Fill in the blanks. 
2. Print out completed form. 
3. Mail with donation to:
Jewish Federation of Lane County,
P.O. Box 5924,
Eugene, OR 97405

2012 Pledge Campaign: All Federation activities are funded by community donations

©2012 Jewish Federation of Lane County