Gift of Israel -Request for funds for a trip
This form is to request funds if your child is using the GOI program for a trip other then a synagogue or day school program. Your synagogue or school will provide you with forms which should be returned to them. Please complete this form in full. After completion, you will be sent a PDF via email. Any questions, email If you wish to close your account, please complete a different form -
Your Name: *
Your answer
Your Email: *
Your answer
Student Name: *
Your answer
Synagogue Name: *
Requested Funds
Please insert the amount to be withdrawn from the account. If you do not wish to use all the money, please only fill in the amount you are using.
Account Balance (leave blank if unknown):
Your answer
Trip/program Information
Enter the name and address where the check should be sent. If this is a synagogue or day school trip, the form should be sent to them.
Program Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zipcode *
Your answer
I am interested in making a donation to support Israel programs. Please contact me.
I authorize the Jewish Federation of Southern NJ to withdraw funds from my childs Gift of Israel account *
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