MACHZOR DONATION FORM 
I wish to donate Machzorim to Chevrei Tzedek for the donation fee of $36.00 each. 

Enclosed is my check to Chevrei Tzedek.

Please mark the Machzorim bookplate(s) as follows: 

In memory of _______________________ by ________________________________ 

In memory of _______________________ by ________________________________ 

In honor of _________________________ by ________________________________ 

In honor of _________________________ by _______________________________ 

(Use additional sheets of paper if you wish or write neatly on the back.) 

If you prefer some other wording, please designate below. 

______________________________________________________________________ 

______________________________________________________________________ 

Please print clearly! 
 

I am donating a total of # ______________ Machzorim, and therefore, my check for 

_________ Machzorim X $_________ = $____________is enclosed. 
 
 Name: ___________________________ 

Address: _________________________ 

                __________________________

                 __________________________ 
 

PHONE (if we need to check spelling) ____________________ 

EMAIL: _______________________________