Congregation Ohav Zedek

Congregation Ohav Zedek Contribution Form

Donor Information

	Name

Email Address

	Street Address	Apt / PO Box

City: State: Zip Code:

Recipient Information

	Name

	Street Address	Apt / PO Box

City: State: Zip Code:

Fund: Amount:

Contribution Occasion:

Additional comments/instructions

Congregation Ohav Zedek
242 South Franklin Street
Wilkes-Barre, PA 18701
570.825.6619