Dedicate a Leaf in honor of a Bar/Bat Mitzvah, Wedding, Birthday, Child's Birth,
Anniversary, Graduation, Promotion, in honor of your Family or the Shul.

Donation per leaf-
Gold leaf: $2,500; Bronze leaf: $1,000 (can be paid over ten months).

This custom-made amazing piece of work was commissioned, designed and sponsored by Tami and Dr. Glen Ruben to honor the memory of their departed loved ones.

For information, please call 516-767-8672

DONOR INFORMATION (individual ordering the Leaf)
First name    State
Last name   Zip
Address   Email
City   Phone
I would like to dedicate
gold leaf/ves | I would like to dedicate bronze leaf/ves.
Please inscribe the following message on the leaf:
Full payment Ten Payments
Name on card   Amount to be charged
Card Number   Card Type
Exp. Date     CVV Code  3 digits on back of card