Buffalo Jewish Federation Payment Form

This form is to be used for payments towards existing pledges.

Pledge Reference Code

Please enter the reference code found on your statement. If you do have not have one, please leave blank.

Payment Amount:

Contact Information

First Name

Last Name

Mobile Phone

Street Address

City

Country

State

Provinces

Postal Code

Payment Information

Name on Card

Card Number

MM (2 Digit)

YY (2 Digit)

Code

I will cover the 3% credit card processing fee to ensure my gift has the greatest impact.

Payment to be Processed

Subtotal:

Processing Fee Amount

Total:

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