At this time we regret that we do not have the funds to set up a secure data transfer that would allow individuals to make on-line credit card donations to The Committee For Rachel's Tomb.  Those interested in making a credit card donation to the Committee  may do so by printing this form and sending it by standard post or via fax.  Faxing this form back to us would be most desirable as it would undoubtably be the most secure method.  The postal addresses and fax number may be found at the bottom of this page.

Name of the individual donating:_____________________________________________

Address:__________________________________________________________________

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Credit Card Organization:

   O Visa           O  Mastercharge        O American Express       O Other, please specify:

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Name exactly as it appears on the credit card:__________________________________

Credit Card Number:_______________________________________________________

Expiration Date on Credit Card:______________________________________________

Would you like to make a one-time donation or distribute your donation over a period of months?  Please specify:

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Please send this form when completed to...