Hillel Donation Form


Preserve Jewish Life at Stony Brook University
Other Amount
Please designate my gift to
 Hillel  Shabbat and Holiday Programming  Podolnick Scholarship Fund  Student Internships
 Kesher Refuah-Hillel  Israel Programming  Student Leadership Initiatives  Parents and Families Shabbaton
Please designate the indicated amount to Podolnick Scholarship Fund.
I would like this to be a recurring gift
 Yes  No
If yes
 Once a Month  Every 3 Months  Once a Year
This gift will be
 in memory of  in honor of  to congratulate  other
Please notify them at (address or email)

Donor Information:

 Mr.  Mrs.  Ms.  Dr.  Professor  Rabbi  
*First Name
*Last Name
*Zip Code
*Email Address
Home or Cell number
 Home  Cell
Are you an alumnus?
 Yes  No
If yes, class of?
Are you a parent/grandparent of a student
 Yes  No
If yes, class of?
Suggestions for future programs initiatives

Payment Information:

Type of Card
 Mastercard  Visa  American Express  
Name on Card
Credit Card Number
Expiration Date

You may also make your donation by check to the Hillel Foundation. Kindly mail your gift to:


Snyder Hillel Center

Melville Library N5580

Stony Brook University 

Stony Brook, NY 11794-3370