- Support Jewish Life at Stony Brook

Support Jewish Life at Stony Brook University

1080
720
540
360
180
72
54

Please indicate a different amount not listed above.

Please designate my gift to (you may choose multiple)

Hillel General Program Fund	Center for Israel Education & Engagement
Podolnick Scholarship Fund	Kesher Refuah Medical Mission to Israel
Student Internships	Student Leadership Initiatives
Shabbat and Holiday Programming	Passover Seder for Students
Rabbi Joseph S. Topek Student Leadership Fund

Please designate the amount per fund selected

I would like this to be a recurring gift

Once a Month
Every 3 Months
Once a Year

Occasion for Gift:

This gift will be

in memory of
in honor of
to congratulate

Whom do you want to recognize

Your relationship to them

Occasion for gift

If you would like someone to be notified of your gift, please provide name and contact information

Donor Information:

Title

*First Name

*Last Name

*Address

*City

*State

*Zip Code

*Email Address

Home Phone

Cell Phone

Campus Affiliation:

Are you faculty/staff? Department/office

Are you an alumnus? Class of

Are you a parent/grandparent of a student

Parent/Guardian	Grandparent

Name of Student(s)

Class of

Payment Information:

Type of Card

Mastercard
Visa
American Express

Name on Card

Credit Card Number

Total

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