Order Your Cards

Cards ordered after Friday, March 10th, 11:00 AM EST will be mailed after Purim.

Fill out the information below and Chai Lifeline will mail the cards out on your behalf.

I would like to order cards at $3.00 per card.
For large quantities, please contact the office at (212)-699-6655

Enter the information exactly how you want it displayed.
   
I would like to contribute the minimum suggested: $
I would like to contribute a total of: $
Your donation amount will be:      $
 
Customer Billing Information
Your billing address must be entered exactly
as it appears on your credit card statement.		 Credit Card Payment Information:
First Name:
Last Name:
Company Name:
Address:
City:
State/Prov:
Zip Code:
Country:
Phone Number:
Email Address:
Card Type:
Card Number:
Expiration Month:
Expiration Year:
Verification Code:
This is the 3 or 4 digit number printed on the back signature panel. It is on the front of the card for American Express.
Comments:
  


required fields
Please mail a receipt to the address above (in addition to the receipt I will receive via email).


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© 2017 Chai Lifeline
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