75th anniversary journal cantor page order form

75TH ANNIVERSARY JOURNAL: CANTOR PAGE ORDER FORM

Name*
Prefix First Last Suffix
Congregation
(if applicable)
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Best Phone Number to Reach You*
Email*
Page Type*
Please select one.
Please e-mail all photographs (hi-res only) & biographies to cantorjc@aol.com or upload below.
Upload Bio & Photos here
Drop files here or

Accepted file types: jpg, eps, tif, png, pdf, txt, doc, docx.
Ma'alim Bikdusha
Our goal is for every colleague to have a full page, regardless of finances. Please consider this additional donation to elevate a fellow colleague to the next level. $180 recommended.
Additional Donation to the Cantors Assembly
If you're paying by credit card, please consider checking the box below to add 3% to your order total to cover our transaction fees.
- Okay
3% to cover credit card processing fees
Price: $0.00
Total Contribution
100% Tax Deductible
$0.00
Payment Information
Please send a check payable to: Cantors Assembly, 75th Anniversary Journal 55 South Miller Road, Suite 201 Fairlawn, OH 44333
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name