Thank you for your interest in supporting Village Chabad! Your support makes you an important partner in our vital task of strengthening Jewish identity, unity and commitment.

Please make out your check to Chabad of Stony Brook and mail it to:

Village Chabad 
360 Nicolls Rd. 
East Setauket, NY 11733

If you'd like to give us more specific information or would like to give us your credit card information by mail, please print and fill out the form below and send it to the same address.

Thank you very much!

Rabbi Chaim Grossbaum
Director, Chabad at Stony Brook

Payment Method:

   Enclosed is my check
   Please charge my credit or debit card account using the information provided below.

I'm happy to make a tax-deductible contribution to Chabad at Stony Brook of:  

 $18 Chai             $36 Double Chai     $54 Triple Chai    $72 Associate  

 $150 Friend       $180 Sponsor         $360 Patron          $500 Benefactor  
     
 $1000 Partner    $1800 Chai Partner   $2500 Partner

 Other ____________

 MasterCard    VISA     American Express 

Card Number:  ________-_________-_________-_________   Exp. Date (mm/yy) ______/______

 Please contact me to set up a meeting



 

 
Your First & Last Name: ______________________________________
Address: ______________________________________
  ______________________________________
City, State, Zip: ______________________________________
Country
(if outside U.S.A.):		 ______________________________________
E-Mail address: ______________________________________
Daytime Phone: (____)______________________
Evening Phone: (____)______________________



 

 

If you would you like this gift to be a tribute, please answer the following:

SELECT ONE.

This gift is...
   In Memory of
   In Honor of

To Mark a Special Occasion: 
   Birthday
   Bar/Bat Mitzvah
   Anniversary
   Other _____________


Honoree's Name:

_____________________________________



 

To have notification card(s) sent, please complete the following.

I would like a notification card without the gift amount mailed to:

Name: ______________________________________
Address: ______________________________________
  ______________________________________
City, State, Zip: ______________________________________
Country (if outside U.S.A.): ______________________________________
From (Your name as you would like it to appear on the card): ______________________________________



 

 

I would like a second notification card without the gift amount mailed to:

Name: ______________________________________
Address: ______________________________________
  ______________________________________
City, State, Zip: ______________________________________
Country (if outside U.S.A.): ______________________________________
From (Your name as you would like it to appear on the card): ______________________________________