JEWISH CHILDREN’S REGIONAL SERVICE

(FORMERLY THE JEWISH CHILDREN’S HOME)

EST. 1855

 

POST OFFICE BOX 7368                                                              METAIRIE, LA  70010-7368

1-800-729-5277

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       I am enclosing my contribution of $ _______________________________  Date ____________________

                 (Please make checks payable to: Jewish Children’s Regional Service, or payable to: JCRS)

       Donor’s Name _________________________________________________________________________________

       Donor’s Address _______________________________________________________________________________

  o   In honor of ________________________________________________________________________________

  o   In memory of _________________________________________________   Is the death recent? oYes  oNo

       Acknowledge to _______________________________________________________________________________

       Address _____________________________________________________________________________________

       How is Honoree/Deceased related to you ____________________________________________________________

       How is Honoree/Deceased related to recipient of Acknowledgment _______________________________________

       Would you like a copy of our most recent newsletter?           o  Yes, please send a copy to me/us.

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In addition to your confirmation letter, we will provide to you a copy of each personalized letter/letters sent to the person/persons you designate for receipt of the Acknowledgment as the honoree or for the memoriam.

Use the Print option on your browser to get a copy of this form.  If you are unable to print the form or would prefer to have a form mailed to you, please call the number above or go to the Contact Us page and select the MoreInfo option to send your request by e-mail.