Humash Etz Hayim - Book Dedication
____ Label ____ Invoice ____ Card ______ Book Plate (FOR OFFICE USE ONLY)

You will be invoiced $72.00 for each donation. Each donation must be filled out separately.

*Underwritten by the Leonard & Irwin Kamp Foundation*

Today's Date *
Qty of Humashim *
From: *
Your answer
Address of Donor (Street, City, State, Zip) *
Your answer
Phone Number of Donor *
Your answer
Email Address of Donor *
Your answer
Recipient: *
Your answer
Type of Donation *
Who is this donation in honor/memory/celebration of: *
Special messages can be typed below.
Your answer
Do you want an acknowledgement card sent to the recipient? *
If yes, please provide the recipient's address.
Your answer
Special Message:
The inscription in the acknowledgement card. Limited to 150 characters.
Your answer
Let us know if you have any special instructions.
Your answer
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