Become a pillar of A Cable to Jewish Life – Subscribe to monthly Automatic Credit Card Donations

You can now support A Cable to Jewish Life on a steady basis.

By pledging to donate periodically.

This way A Cable to Jewish Life will continue to serve the Jewish community without interruption.

Please fill out the form below to help insure the future of the programming of A Cable to Jewish Life

A Cable to Jewish Life - Automatic Credit Card Donation, Billing Authorization Form

To enjoy the convenience of automatic billing, simply complete the Credit Card Information section below and sign the form. All requested information is required. Upon approval, we will bill your credit card for the amount indicated and your donation will appear on your monthly credit card statement. You may cancel this automatic billing authorization at any time by contacting Cablejew@aol.com.

This service is provided by Quickbooks Merchant Services - secure credit card processing service.

Donor Information

Donor name:

Donor Address:

Donor account #:

Phone: - -

Donation Information

I authorize A Cable to Jewish Life to automatically bill the card listed below as specified:

Donation Amount: $

Frequency:r Weekly rBi-Weekly r Semi-Monthly r Monthly r Quarterly r Semi-Annually r Annually
(Check only one)

Start billing on: / /

End billing when:

r Contract expires: / /

r Donor provides written cancellation

Credit Card Information (To be completed by Donor)

A Cable to Jewish Life accepts the following credit cards: rVisa rMasterCard rAmerican Express rDiscover

Credit card # 
Exp. Date


Cardholder's name:

(as shown on credit card)

Cardholder's Zip code (required): -

(from credit card billing address)

Cardholder's signature:

Date: / /

Please print this form

After you complete this form please mail to:

A Cable to Jewish Life

383 Kingston Ave #323

Brooklyn, NY 11213

Or fax to: 347-402-1424