<!DOCTYPE html>

<html xmlns="http://www.w3.org/1999/xhtml" lang="en" xml:lang="en">
<head>
<meta http-equiv="X-UA-Compatible" content="IE=edge" />
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta http-equiv="Content-Language" content="en" />

<meta property="og:image" content="https://w2.chabad.org/media/images/1332/nrUC13326254.png" itemprop="image" width="150" height="150" />
<meta property="og:image:width" content="150" />
<meta property="og:image:height" content="150" />
<meta name="viewport" content="width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=0" />
<meta name="keywords" content="Printable,Mail,Form" />
<meta name="title" content="Printable Mail Form - Chabad Lubavitch of Coconut Creek &amp; W Pompano Beach Fl Florida" />
<meta property="og:type" content="website" />
<meta name="scope-aids" content="62464-62468-281531-281574" />
<meta name="article-keywords" content="6760-2170-2898" />
<meta name="scope-aid" content="62464" />
<meta name="scope-aid" content="62468" />
<meta name="scope-aid" content="281531" />
<meta name="scope-aid" content="281574" />
<meta name="article-keyword" content="6760" />
<meta name="article-keyword" content="2170" />
<meta name="article-keyword" content="2898" />
<meta property="og:url" content="https://www.chabadcoconutcreek.com/templates/articlecco_cdo/aid/281574/jewish/Printable-Mail-Form.htm" />
<meta property="twitter:card" content="summary_large_image" />
<meta property="twitter:site" content="@chabad" />
<meta property="og:title" content="Printable Mail Form - Chabad Lubavitch of Coconut Creek &amp; W Pompano Beach Fl Florida" /><link rel="canonical" href="https://www.chabadcoconutcreek.com/templates/articlecco_cdo/aid/281574/jewish/Printable-Mail-Form.htm" />
<link rel="icon" type="image/png" href="https://www.chabadcoconutcreek.com/media/images/1332/nrUC13326254.png" />
<link rel="Stylesheet" href="/css/fonts/font-awesome/font-awesome-5.css?v=98662BF4" id="kfont-awesome" type="text/css"/>
<link rel="Stylesheet" href="/css/DefaultGrid.css?v=44B79007" id="kgrid" type="text/css"/>
<link rel="Stylesheet" href="/css/Elements.css?v=E669C926" id="k6" type="text/css"/>
<link rel="Stylesheet" href="/css/vendor/ds/tokens/sites.css?v=D77AD1C0" id="ksites-ds-css" type="text/css"/>
<link rel="Stylesheet" href="/css/new/main.css?v=2B7F734E" id="k7" type="text/css"/>
<link rel="Stylesheet" href="/css/global.css?v=D37C5613" id="k3" type="text/css"/>
<link rel="Stylesheet" href="/css/global-print.css?v=1FE80AC1" id="k5" type="text/css" media="print"/>
<link rel="Stylesheet" href="/css/cco/home/widget-styles.css?v=B14CEBA0" id="k6" type="text/css"/>
<link rel="Stylesheet" href="/css/sites6/blue-theme.css?v=876F2038" id="k" type="text/css"/>
<link rel="Stylesheet" href="/css/old/global.css?v=F7C22456" id="k2898" type="text/css"/>
<link rel="Stylesheet" href="/css/bootstrap/grid.css?v=B92FCAD8" id="kbootstrap4-grid" type="text/css"/>
<link rel="Stylesheet" href="/css/Library/reader-comments.css?v=5F31D0D8" id="kCommentsStylesheet" type="text/css"/>
<link rel="Stylesheet" href="/css/inline/BookInfo.css?v=14B88022" id="kBookInfoCss" type="text/css"/>
<!--[if lte IE 8]> <link rel="Stylesheet" href="/css/global-ie.css?v=E699B0F3" id="k4" type="text/css"/> <![endif]-->
<script>$q=[];$j=function(f){$q.push(f);}</script>
	
<title>
	Printable Mail Form - Chabad Lubavitch of Coconut Creek & W Pompano Beach Fl Florida
</title>
	



<script>
	window.dataLayer = window.dataLayer || [];
	dataLayer.push({"event":"datalayer-initialized","page":{"numberOfComments":0,"publicationDate":"2005-05-22","primaryArticleId":281574,"title":"","author":"","authorId":0,"contentLevel1":"My Site","contentLevel2":"Support Chabad","contentLevel3":"Printable Mail Form","siteName":"Chabad Lubavitch of Coconut Creek & W Pompano Beach Fl Florida"},"time":{"upcomingHoliday":"Shavuot","daysToUpcomingHoliday":5,"hebrewDate":"5786-03-01"}});
		dataLayer.push({ 'articleHierarchy': '-62464-62468-281531-281574-', 'keywords': '-k2898-k2170-k6760-', 'k': '-62464-62468-281531-281574--k2898-k2170-k6760-' });
	
</script>
<script>

(function(c,h,a,b,a,d){c[a]=c[a]||[];c[a].push({'gtm.start':
new Date().getTime(),event:'gtm.js'});var f=h.getElementsByTagName(b)[0],
j=h.createElement(b);j.async=true;
j.src='https://w6.chabad.org/mitzvah-tank.js';f.parentNode.insertBefore(j,f);
})(window,document,0,'script','dataLayer');</script>

	<!-- Start of StatCounter Code -->
	<script type="text/javascript">
	var sc_project = 1076005;var sc_partition = 1;var sc_invisible = 1;var sc_remove_link=1;var sc_security = "2c2ae2b7";var sc_https = 1;
	</script>
	<script type="text/javascript" src="https://secure.statcounter.com/counter/counter_xhtml.js" defer async></script>
	<noscript><img src="//c2.statcounter.com/counter.php?sc_project=1076005&amp;java=0&amp;security=2c2ae2b7&amp;invisible=1" border="0" /> </noscript>
	<!-- End of StatCounter Code -->

</head>
<body class="lang_en dir_ltr cco_body sites-article">

	


	
	<div id="PrintCreditHeader" class="show_for_print">
Printed from<b>ChabadCoconutCreek.com</b>
</div>
	<div id="header">
		<div class="wrapper header-wrapper">
			
			


<div id="header_container" class="header_container">
	<div class="clearfix links">
		<img src="https://w2.chabad.org/images/global/spacer.gif" width="15" height="8" class="baruch_hashem" />
		<div class="float_right">
			
			
				<div class="topBarLink cco_topbar_link ask_the_rabbi_link">
					<a href="/asktherabbi/default_cdo/jewish/Ask-the-Rabbi.htm">Ask the Rabbi</a>
				</div>
				
			
			
				<div class="topBarLink cco_topbar_link contact_link">
					<a href="/tools/feedback.asp">Contact</a>
				</div>
			
			
		</div>
		<div class="float_left">
			
				<div class="topBarLink cco_topbar_link home_link">
					<a href="/">Home</a>
				</div>
				
			
				<div class="topBarLink cco_topbar_link about_link">
					<a href="/329376">About</a>
				</div>
				
			
			
			
		</div>
	</div>
	<div class="break_floats"></div>
</div>

			<div class="clearfix branding-search">
				<div id="header_branding" class="no_outline  logo">
					<div class="g260 no_margin cco_search_header float_right">
						

<div class="co_search_form margin05">
	<form name="MainSearchForm" id="MainSearchForm" method="get" action="/search/results.asp" class="clearfix" onsubmit="return Co.Forms.Validation.Validate(this, null, {markAsSubmitted:false});">
		<div class="co_global_submit"><button type="submit" class="button" value=" "><span> </span></button></div>
		

<div class="co_global_input_container clearfix">
	<input id="topAreaTopSearch_search" required="true" autocomplete="nope" placeholder="Search" value="" OnAutoSuggestSelect="OnSearchAutoSuggestSelect(ev);" class="co_global_input co_search js-search-field active js-mirrored-input" onblur="this.form.className = this.form.className.replace(/\sactive/gi, &#39;&#39;);" name="searchWord" onfocus="this.form.className+=&#39; active&#39;;" type="text" autoSuggestProperties="&quot;Highlight&quot;:true,&quot;Name&quot;:&quot;topAreaTopSearch_search&quot;,&quot;AutoSubmit&quot;:true,&quot;ShowRecommendedOnTop&quot;:false" autoSuggestUrl="/WebServices/RemoteCall/Get_Suggestions" display_name="Search Field" min_length="3"></input>
</div>

			
		
		
	
		<div id="topAreaTopSearch_search_wrapper" class="co_field_options" style="display:none;">
			<div class="co_absolute_wraper" id="co_absolute_wraper" style="">
				<div class="inner">
					<div id="topAreaTopSearch_search_container" class="co_field_options_suggestions"></div>
					<div class="break_floats"></div>
					
				</div>
			</div>
		</div>
	</form>
</div>
					</div>
					
						<div class="float_left site-logo-wrapper"><a href="/"><img src="https://w2.chabad.org/media/images/1332/nrUC13326254.png" width="100" height="100" border="0"  /></a></div>
					
					<a href="/default.asp" title="Chabad Lubavitch of Coconut Creek & W Pompano Beach Fl Florida" class="site_title">Chabad Lubavitch of Coconut Creek & W Pompano Beach Fl Florida<span class="site_subtitle clearfix"></span></a>
				</div>
			</div>
			
			
			<button type='button' class='cs-mobile-menu-open js-mobile-menu-open'><i class='fa fa-bars'></i></button>
			<div class="site-nav-wrapper">
				<script>
var primaryNavigationVersion = "637841160000000000";
</script>
<div id="co_menu_container_wrapper" class="co_menu_container_wrapper " data-list-name="primary navigation"> 
<div class="co_menu_container clearfix" id="co_menu_container">
<a class="menu_logo" href="/"></a>
<table cellpadding="0" cellspacing="0" border="0" class="main_menu_container first global">
<tr id="tabContentMain" tab="Main" style="display:table-row;">
<td class="co_menu_item home" data-menu-level="1"><a href="/default.asp"><img class="co_menu_home_image" src="https://w2.chabad.org/images/global/spacer.gif" width="28" height="60" border="0" onmouseover="this.className += ' hover';" onmouseout="this.className=this.className.replace(/\s?hover/gi, '');" /></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item arrow multi_level" aid="3111465" data-menu-level="1" onmouseover='Co.MainNavigation.Show(event, this);' onmouseout='Co.MainNavigation.Hide(event, this);' >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
<div class="co_column">
<a href="/templates/articlecco_cdo/aid/3111467/jewish/Changing-Jewish-Destiny.htm" class="item hover" id="menu_item1-1" data-menu-level="2" data-aid="3111466">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Why Giving Matters</span>
</a>
<a href="/templates/articlecco_cdo/aid/3111480/jewish/Bequest.htm" class="item" id="menu_item1-2" data-menu-level="2" data-aid="3111479">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Ways To Give</span>
</a>
<a href="/templates/articlecco_cdo/aid/3111489/jewish/Jewish-Legacy-Society.htm" class="item" id="menu_item1-3" data-menu-level="2" data-aid="3111488">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Gratitude</span>
</a>
<a href="/templates/articlecco_cdo/aid/3111493/jewish/Bequest-Form.htm" class="item" id="menu_item1-4" data-menu-level="2" data-aid="3111492">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Resources</span>
</a>
<a href="/templates/articlecco_cdo/aid/3111499/jewish/Contact-Us.htm" class="item" id="menu_item1-5" data-menu-level="2" data-aid="3111498">
<img src="https://w2.chabad.org/images/global/spacer.gif" width="5" height="10" alt="" border="0" class="arrow" />
<span>Contact</span>
</a>
</div>
<div id="menu_child1-1" class="menu_child selected" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/3111467/jewish/Changing-Jewish-Destiny.htm" class="child_item default" data-menu-level="3" data-aid="3111467"><span>Changing Jewish Destiny</span></a>
<a href="/news" class="child_item default" data-menu-level="3" data-aid="3111468"><span>Chabad In The News</span></a>
<a href="/templates/articlecco_cdo/aid/3111469/jewish/The-Rebbes-Mandate.htm" class="child_item link" data-menu-level="3" data-aid="3111469"><span>The Rebbe's Mandate</span></a>
<a href="/charity" class="child_item default" data-menu-level="3" data-aid="3111470"><span>Giving In Jewish Tradition</span></a>
<a href="/templates/articlecco_cdo/aid/3111471/jewish/Donor-Stories.htm" class="child_item link" data-menu-level="3" data-aid="3111471"><span>Donor Stories</span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child1-2" class="menu_child" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/3111480/jewish/Bequest.htm" class="child_item default" data-menu-level="3" data-aid="3111480"><span>Bequest</span></a>
<a href="/templates/articlecco_cdo/aid/3111481/jewish/Charitable-Gift-Annuity.htm" class="child_item default" data-menu-level="3" data-aid="3111481"><span>Charitable Gift Annuity</span></a>
<a href="/templates/articlecco_cdo/aid/3111482/jewish/Real-Estate.htm" class="child_item default" data-menu-level="3" data-aid="3111482"><span>Real Estate</span></a>
<a href="/templates/articlecco_cdo/aid/3111483/jewish/Life-Insurance.htm" class="child_item default" data-menu-level="3" data-aid="3111483"><span>Life Insurance</span></a>
<a href="/templates/articlecco_cdo/aid/3111484/jewish/Charitable-Trusts.htm" class="child_item default" data-menu-level="3" data-aid="3111484"><span>Charitable Trusts</span></a>
<a href="/templates/articlecco_cdo/aid/3111485/jewish/Retirement-Plans.htm" class="child_item default" data-menu-level="3" data-aid="3111485"><span>Retirement Plans</span></a>
<a href="/templates/articlecco_cdo/aid/3111486/jewish/Planned-Giving-Videos.htm" class="child_item default" data-menu-level="3" data-aid="3111486"><span>Planned Giving Videos</span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child1-3" class="menu_child" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/3111489/jewish/Jewish-Legacy-Society.htm" class="child_item default" data-menu-level="3" data-aid="3111489"><span>Jewish Legacy Society</span></a>
<a href="/templates/articlecco_cdo/aid/3111490/jewish/My-Story.htm" class="child_item default" data-menu-level="3" data-aid="3111490"><span>My Story</span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child1-4" class="menu_child" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/3111493/jewish/Bequest-Form.htm" class="child_item default" data-menu-level="3" data-aid="3111493"><span>Bequest Form</span></a>
<a href="/templates/articlecco_cdo/aid/3111494/jewish/Frequently-Asked-Questions.htm" class="child_item link" data-menu-level="3" data-aid="3111494"><span>Frequently Asked Questions</span></a>
<a href="/templates/articlecco_cdo/aid/3111495/jewish/Advisor-Information.htm" class="child_item default" data-menu-level="3" data-aid="3111495"><span>Advisor Information</span></a>
<a href="/templates/articlecco_cdo/aid/3111496/jewish/Planned-Giving-Council.htm" class="child_item default" data-menu-level="3" data-aid="3111496"><span>Planned Giving Council</span></a>
<a href="/templates/articlecco_cdo/aid/3111497/jewish/Glossary-of-Terms.htm" class="child_item link" data-menu-level="3" data-aid="3111497"><span>Glossary of Terms</span></a>
</div></td>
</tr>
</table>
</div>
<div id="menu_child1-5" class="menu_child" style="width:174px;">
<table cellpadding="0" cellspacing="0" border="0" style="height:100%;">
<tr class="wrapper clearfix">
<td class="co_column"><div class="column_left_wrapper">
<a href="/templates/articlecco_cdo/aid/3111499/jewish/Contact-Us.htm" class="child_item default" data-menu-level="3" data-aid="3111499"><span>Contact Us</span></a>
<a href="/templates/articlecco_cdo/aid/3111500/jewish/Share-Your-Story.htm" class="child_item default" data-menu-level="3" data-aid="3111500"><span>Share Your Story</span></a>
</div></td>
</tr>
</table>
</div>
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><img src="https://w2.chabad.org/images/global/spacer.gif" width="12" height="6" border="0" vspace="2" /><div><a href="/templates/section_cdo/aid/3111465/jewish/Planned-Giving.htm" class="parent">Planned<br />Giving</a></div></span><a href="/templates/section_cdo/aid/3111465/jewish/Planned-Giving.htm" class="bg_extension js-parent-menu-link" data-aid="3111465"></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item" aid="401674" data-menu-level="1" onmouseover="this.className += ' hover';" onmouseout="this.className = this.className.replace(/\shover/gi, '');" >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><div><a href="/templates/articlecco_cdo/aid/401674/jewish/Order-Shofars-online.htm" class="parent">Order&nbsp;Shofars<br />online</a></div></span><a href="/templates/articlecco_cdo/aid/401674/jewish/Order-Shofars-online.htm" class="bg_extension js-parent-menu-link" data-aid="401674"></a></td>
<td class="co_menu_item_divider"><img src="https://w2.chabad.org/images/global/spacer.gif" width="2" height="1" border="0" /></td>
<td class="co_menu_item donate_link" aid="0" data-menu-level="1" onmouseover="this.className += ' hover';" onmouseout="this.className = this.className.replace(/\shover/gi, '');" >
<div class="co_menu_content"><div class="co_submenu_container" style="width:auto;display:none;clip:rect(auto auto 0px auto);">
<div class="wrapper">
<div class="column_wrapper clearfix" style="height:100%;">
</div>
<div class="break_floats"></div></div></div></div><span class="parent"><div><a href="/3254238" class="parent">Donate</a></div></span><a href="/3254238" class="bg_extension js-parent-menu-link" data-aid="0"></a></td>
</tr>
</table>
</div>
</div>
<!-- END CACHE -->
				<div class="mobile-menu-bottom-links">
					
						<a href="/329376" class="site-menu-general__link">About</a>
					
					<a href="/search">Search</a>
					
						<a href="/tools/feedback.asp">Contact</a>
					
				</div>
			</div>
		</div>
	</div>
	<div id="content">
		<div id="BodyContainer" class="wrapper">
			<div class="body_wrapper  no-hero-image clearfix">
				
	<div class="co_content_container clearfix local_content" id="co_content_container">
		<div class="clearfix">
			
			
			
			<div class="clearfix bh mobile-only align_right">ב"ה</div>
			
				<div class="master-content-wrapper g960" >
					

<header class="article-header cf ">
	
<script type="application/ld+json">
{
	"@context": "http://schema.org",
	"@type": "BreadcrumbList",
	"itemListElement": [
  {
    "@type": "ListItem",
    "position": 1,
    "item": {
      "@id": "/templates/articlecco_cdo/aid/281531/jewish/Support-Chabad.htm",
      "name": "Support Chabad"
    }
  },
  {
    "@type": "ListItem",
    "position": 2,
    "item": {
      "@id": "/article.asp?aid=281574",
      "name": "Printable Mail Form"
    }
  }
]
}
</script>
<div class="breadcrumbs breadcrumbs hide_for_print" data-list-name="breadcrumbs">
	
			<a class="breadcrumbs__crumb" href='/templates/articlecco_cdo/aid/281531/jewish/Support-Chabad.htm' data-aid="281531">
				Support Chabad
			</a>
		
</div>
	
			<h1 class="article-header__title js-article-title js-page-title">Printable Mail Form</h1>
		
			<div>
				
			</div>
		
</header>
				</div>
			
			<div class="body_wrapper clearfix co_body">
				<div class="g960" id="co_body_container">
					
					<div id="ContentBody">
						
						
							<div class="content-area-parent no_margin">
								
	<div id="cco_body">
		<div class="content g960 no_margin no_overflow" id="co_content_container">
			
			
	

	<article class="content js-content" itemscope itemtype="http://schema.org/Article">
	



<meta itemprop="mainEntityOfPage headline name" content="" />

<meta itemprop="image" content="" />


<meta itemprop="uploadDate" content="2005-05-22T13:09:03" />
<span itemprop="publisher" itemscope itemtype="http://schema.org/Organization">
	<meta itemprop="name" content="Chabad Lubavitch of Coconut Creek &amp; W Pompano Beach Fl Florida" />
	<meta itemprop="brand" content="Chabad Lubavitch of Coconut Creek &amp; W Pompano Beach Fl Florida" />
	<span itemprop="logo" itemscope itemtype="http://schema.org/ImageObject">
		<meta itemprop="url" content="https://w2.chabad.org/media/images/1332/nrUC13326254.png" />
		<meta itemprop="height" content="150" />
		<meta itemprop="width" content="150" />
	</span>
</span>
<meta itemprop="datePublished" content="2005-05-22T13:09:03" />
			<div itemprop="articleBody">
				<co:body xmlns:co="www1.chabadonline.com/alpha1" xmlns:ext="urn:xslt-extensions">
  <div class="co_body article-body cf">
<table class="covertype" style="WIDTH: 729px; HEIGHT: 42px" cellspacing="0" cellpadding="2" width="729" bgcolor="#C6C9EA" border="0">
<tbody>
<tr>
<td width="55">
<div align="left">
<span style="FONT-SIZE: 12pt; FONT-FAMILY: Times New Roman">Donation Options:</span></div>
</td>
<td width="52">
<div align="center">
<a href="https://secure.usaepay.com/interface/epayform/nl61j19tJsxD8oFPY1YQF2988vLYP1k3/"><span style="FONT-SIZE: 12pt; FONT-FAMILY: Times New Roman">Donate Online</span></a></div>
</td>
<td width="54">
<div align="center">
<a href="/Article.asp?AID=281574"><span style="FONT-SIZE: 12pt; FONT-FAMILY: Times New Roman">Donate by Mail</span></a></div>
</td>
<td width="67">
<div align="center">
<a href="/Article.asp?AID=276630"><span style="FONT-SIZE: 12pt; FONT-FAMILY: Times New Roman">Donate your Car</span></a></div>
</td>
<td width="85">
<div align="center">
<a href="/Article.asp?AID=290699"><span style="FONT-SIZE: 12pt; FONT-FAMILY: Times New Roman">Website/Email Dedication</span></a></div>
</td>
<td width="126">
<div align="center">
<a href="/admin/Publishing/mailtDonate@chabadcoconutcreek.com"><span style="FONT-SIZE: 12pt; FONT-FAMILY: Times New Roman">Donate your Land, Property, or Stock</span></a></div>
</td>
<td width="56">
<p align="center">
<a href="/admin/Publishing/mailtdonate@chabadcoconutcreek.com"><font class="covertype"> <span style="FONT-SIZE: 12pt; FONT-FAMILY: Times New Roman">Donate In-Kind</span></font></a></p>
</td>
<td width="52">
<p align="center">
<a href="/Article.asp?AID=284961"><span style="FONT-SIZE: 12pt; FONT-FAMILY: Times New Roman">Sponsor a Game</span></a></p>
</td>
<td width="80">
<div align="center">
<a href="/Article.asp?AID=292526"><span style="FONT-SIZE: 12pt; FONT-FAMILY: Times New Roman">Donate while you shop</span></a></div>
</td>
</tr>
</tbody>
</table>
<table height="100" cellspacing="0" cellpadding="0" width="723" align="center" border="0">
<tbody>
<tr>
<td width="521">
<p align="left">
<font face="" size="2"><img height="1" src="http://www.chabadfivetowns.com/admin/publishing/Donate%20%20Chabad_org_files/spacer.gif" width="100%" alt=""></font>
            </p>
</td>
<td valign="top" width="3" background="/admin/Publishing/Donate%20Chabad_org_files/doted-line2.gif" bgcolor="#CCCCCC" rowspan="2">
<p align="left">
<font face="" size="2"><img height="5" src="http://www.chabadfivetowns.com/admin/publishing/Donate%20%20Chabad_org_files/whitespacer.gif" width="1" alt=""></font>
            </p>
</td>
<td width="6" rowspan="2">
<p align="left"> </p>
</td>
<td valign="top" align="middle" width="185" rowspan="2">
<div align="left">
<table cellspacing="0" cellpadding="0" width="100%" align="left" border="0">
<tbody>
<tr>
<td>
<p>
<font face="" size="2"><img height="215" src="http://www.chabadfivetowns.com/media/images/44/bKrZ445457.jpg" width="180" alt=""><br>
<img height="2" src="http://www.chabadfivetowns.com/admin/publishing/Donate%20%20Chabad_org_files/spacer.gif" width="1" alt=""><br>
</font><span class="covertype"><font class="covertype"> <font face="Times New Roman"> <font size="1"><strong>Who We Serve</strong> <br>
                        Chabad of Coconut Creek &amp; W. Pompano Beach is dedicated to providing every Jew regardless of background, philosophy or level of commitment, an open door environment for strengthening and enhancing Jewish family life.  Chabad serves individuals and  families looking for an anchor and non-judgmental, accepting, personalized Jewish experience.</font>
                            </font>
                          </font></span></p>
<p>
<span class="covertype"><font class="covertype">
                            <font face="Times New Roman" size="1">Chabad offers Judaism with a smile, and a home away from home for everyone who walks through its doors.  <br>
</font><a href="http://www.chabadcoconutcreek.com/global/about/article.asp?AID=244369"><font face="Times New Roman" color="#000000" size="1">More About Us... </font></a> <br>
<font face="Times New Roman" size="1"><img height="4" src="http://www.chabadfivetowns.com/admin/publishing/Donate%20%20Chabad_org_files/spacer.gif" width="1" alt=""><br>
<img height="50" src="http://www.chabadfivetowns.com/media/images/84730.gif" width="180" alt=""></font>
                            <font face="Times New Roman" size="1"><br>
</font>
                            <font face="Times New Roman" size="1"><img height="4" src="http://www.chabadfivetowns.com/admin/publishing/Donate%20%20Chabad_org_files/spacer.gif" width="1" alt=""><br>
<img height="1" src="http://www.chabadfivetowns.com/media/images/84878.gif" width="180" vspace="2" alt="">  <br>
<br>
                        Chabad Lubavitch of Coconut Creek &amp; W. Pompano Beach is a 501(c)3 charity and all contributions to it are tax deductible.   All online contributions will be acknowledged within 48 hours. <br>
<br>
<img height="1" src="http://www.chabadfivetowns.com/media/images/84878.gif" width="180" vspace="3" alt=""></font>
                          </font>
                          <font face="Times New Roman">
                            <font size="1"> <!--<table width="100%" border="0" cellspacing="2" cellpadding="2" bgcolor="#F5F5F5">
                    <tr> 
                      <td><span class="tiny"><font class=covertype><font class=covertype><b><font color="#104173">Some 
                        Accomplishment Highlights for the year 5762 (2001-2002)</font></b><br>
                        <img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="5"><br>
                        With your help during this past year we:<br>
                        <img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="5"><br>
                        &middot; Experienced 10% growth in our user/subscriber 
                        audience <br>
                        <img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="5"><br>
                        &middot; Grew our team of authors, responders, programmers 
                        and designers <br>
                        <img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="5"><br>
                        &middot; Responded to 249,000 questions and comments from 
                        people in every corner of this earth <br>
                        <img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="5"><br>
                        &middot; Put into place one of the world&#146;s most sophisticated 
                        content management systems <img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="5"><br>
                        &middot; Expanded our content to 64,500 articles <br>
                        <img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="5"><br>
                        &middot; Published the internet&#146;s first complete 
                        version of Chumash with Rashi <br>
                        <img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="5"><br>
                        &middot; Created the Interactive Weekly Calendar <br>
                        <img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="5"><br>
                        &middot; Refined our Shabbat candle-lighting program to 
                        be the most accurate on the internet<img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="5"><br>
                        &middot; Revamped our design <br>
                        <img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="5"><br>
                        &middot; Created dozens of local portals <br>
                        <img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="5"><br>
                        &middot; And much, much more. <br>
                        <img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="5"><br>
                        With your partnership we look forward to an even more 
                        productive year this year! </font></font></span></td>
                    </tr>
                  </table>--></font>
                          </font></span></p>
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td valign="top" width="521">
<h1 align="center"> </h1>
<h1 align="center">Printable Mail Form</h1>
<p>
<em>Thank you for your interest in supporting Chabad of Coconut Creek &amp; W. Pompano Beach!  <br>
            Your support makes you an important partner in our vital task of strengthening Jewish <br>
            identity, unity and commitment.</em></p>
<p><em>Please make out</em> <em>your check</em> <em>to Chabad of Coconut Creek &amp; W. Pompano Beach <br>
            and send it to:</em></p>
<blockquote>
<p>Chabad of Coconut Creek &amp; W. Pompano Beach <br>
            7530 Lyons Rd <br>
            Coconut Creek, FL 33073</p>
</blockquote>
<p>
<em>If you'd like to give us more specific information or would like to give us your <strong>credit card</strong> information by mail, please print and fill out the form below and send it to the same address.</em></p>
<p>
<em>Thank you very much!</em></p>
<p>
<em>Rabbi Yossi Gansburg <br>
            Director, Chabad of Coconut Creek &amp; W. Pompano Beach</em></p>
<table cellspacing="5" cellpadding="5" width="568" bgcolor="#FFF8E1" border="0">
<tbody>
<tr>
<td>
<h4>Payment Method:</h4>
<p>  <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> Enclosed is my check <br>
                          <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> Please charge my credit or debit card account using the information provided below.</p>
<p>I'm happy to make a tax-deductible contribution to Chabad of Coconut Creek &amp; W. Pompano Beach of:  <br>
<br>
                                   <font size="2"><img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> </font>
                      <font size="1">$18 Chai            <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> $36 Double Chai    <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> $54 Triple Chai   <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> $72 Associate  </font>
                    </p>
<p>
<font size="1">               <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> $150 Friend     <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> $180 Sponsor        <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> $360 Patron         <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> $500 Benefactor  <br>
                             <br>
                                       <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> $1000 Partner   <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> $1800 Chai Partner  <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> $2500 Partner <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> Other ____________</font>
                    </p>
<p><br>
<img height="1" alt="" src="http://www.chabadfivetowns.com/images/global/spacer.gif" width="40"> <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> MasterCard   <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> VISA    <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> American Express </p>
<p>
<font size="2">Card Number:  ________-_________-_________-_________   Exp. Date (mm/yy) ______/______</font>
                    </p>
</td>
</tr>
</tbody>
</table>
<hr>
<table cellspacing="0" cellpadding="5" width="568" bgcolor="#FFF8E1" border="0">
<tbody>
<tr>
<td> </td>
</tr>
<tr>
<td class="blueprint" align="right" width="180">Your First &amp; Last Name:</td>
<td width="360">______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right">Address:</td>
<td>______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right"> </td>
<td>______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right">City, State, Zip:</td>
<td>______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right">Country<font size="2"><br>
                        (if outside U.S.A.)</font>:</td>
<td>______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right">E-Mail address:</td>
<td>______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right">Daytime Phone:</td>
<td>(____)______________________</td>
</tr>
<tr>
<td class="blueprint" align="right">Evening Phone:</td>
<td>(____)______________________</td>
</tr>
</tbody>
</table>
<hr>
<h4>If you would you like this gift to be a tribute, please answer the following:</h4>
<table cellspacing="2" cellpadding="5" border="0">
<tbody>
<tr>
<td valign="top">
<p>SELECT ONE.</p>
</td>
<td>
<p>This gift is... <br>
                          <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> In Memory of <br>
                          <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> In Honor of <br>
<br>
                        To Mark a Special Occasion:  <br>
                          <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> Birthday <br>
                          <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> Bar/Bat Mitzvah <br>
                          <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> Anniversary <br>
                          <img height="13" alt="" src="http://www.chabadfivetowns.com/images/tools/donate/tinybox.gif" width="13"> Other _____________</p>
</td>
<td valign="bottom">
<p><br>
                        Honoree's Name: <br>
<br>
                        _____________________________________</p>
</td>
</tr>
</tbody>
</table>
<h5>To have notification card(s) sent, please complete the following.</h5>
<p>I would like a notification card without the gift amount mailed to:</p>
<table cellspacing="0" cellpadding="3" width="568" bgcolor="#E9E9E9" border="0">
<tbody>
<tr>
<td class="blueprint" align="right" width="200">Name:</td>
<td width="400">______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right">Address:</td>
<td>______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right"> </td>
<td>______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right">City, State, Zip:</td>
<td>______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right">Country <font face="Times New Roman" size="1">(if outside U.S.A.):</font>
                  </td>
<td>
<font face="Times New Roman" size="1">______________________________________</font>
                  </td>
</tr>
<tr>
<td class="blueprint" align="right">
                    <font face="Times New Roman" size="1">From (Your name as you would like it to appear on the card)</font>:</td>
<td>______________________________________</td>
</tr>
</tbody>
</table>
<hr width="300">
<p>I would like a <i>second</i> notification card without the gift amount mailed to:</p>
<table cellspacing="0" cellpadding="3" width="568" bgcolor="#E9E9E9" border="0">
<tbody>
<tr>
<td class="blueprint" align="right" width="200">Name:</td>
<td width="400">______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right">Address:</td>
<td>______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right"> </td>
<td>______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right">City, State, Zip:</td>
<td>______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right">Country <font face="Times New Roman" size="1">(if outside U.S.A.):</font>
                  </td>
<td>______________________________________</td>
</tr>
<tr>
<td class="blueprint" align="right">From <font face="Times New Roman" size="1">(Your name as you would like it to appear on the card):</font>
                  </td>
<td>______________________________________</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</div>
</co:body>
			</div>
			

			<div class="break_floats"></div>
			
	<div class="break_floats"></div>
	

<div class="content-footer">
	<!-- END CACHE -->
	
	
	
	
	
</div>
	</article>

		</div>
	</div>
</div>
						
						<div class="break_floats"></div>
						
					</div>
				</div>
				
				
				
			</div>
			
			
		</div>
		
		<aside class="page-tools-sidebar js-page-tools-sidebar hide_for_print">
<div class="page-tools js-page-tools-menu">
<div class="page-tools__section page-tools__section--share">
<a class="page-tools__tool js-share-popup page-tools__tool--facebook" data-share-url="https://www.facebook.com/dialog/share?app_id=188669250943&amp;display=popup&amp;href=https%3a%2f%2fwww.chabadcoconutcreek.com%2ftemplates%2farticlecco_cdo%2faid%2f281574%2fjewish%2fPrintable-Mail-Form.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dFB">
				<i class="fa fa-facebook"></i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--twitter" data-share-url="https://twitter.com/intent/tweet?text=Printable+Mail+Form+-+Chabad+Lubavitch+of+Coconut+Creek+%26+W+Pompano+Beach+Fl+Florida&amp;url=https%3a%2f%2fwww.chabadcoconutcreek.com%2ftemplates%2farticlecco_cdo%2faid%2f281574%2fjewish%2fPrintable-Mail-Form.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dtwitter&amp;via=Chabad">
				<i class="fa fa-twitter"></i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--whatsapp d-lg-none js-share-whatsapp" data-share-url="whatsapp://send?text=Printable+Mail+Form+-+Chabad+Lubavitch+of+Coconut+Creek+%26+W+Pompano+Beach+Fl+Florida https%3a%2f%2fwww.chabadcoconutcreek.com%2ftemplates%2farticlecco_cdo%2faid%2f281574%2fjewish%2fPrintable-Mail-Form.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dwhatsapp">
				<i class="fa fa-whatsapp">
					<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 50 50" fill="#128c7e" width="1em" height="1em"><path d="M25 2C12.318 2 2 12.318 2 25c0 3.96 1.023 7.854 2.963 11.29L2.037 46.73c-.096.343-.003.711.245.966.191.197.451.304.718.304.08 0 .161-.01.24-.029l10.896-2.699C17.463 47.058 21.21 48 25 48c12.682 0 23-10.318 23-23S37.682 2 25 2zm11.57 31.116c-.492 1.362-2.852 2.605-3.986 2.772-1.018.149-2.306.213-3.72-.231-.857-.27-1.957-.628-3.366-1.229-5.923-2.526-9.791-8.415-10.087-8.804-.295-.389-2.411-3.161-2.411-6.03s1.525-4.28 2.067-4.864c.542-.584 1.181-.73 1.575-.73s.787.005 1.132.021c.363.018.85-.137 1.329 1.001.492 1.168 1.673 4.037 1.819 4.33.148.292.246.633.05 1.022s-.294.632-.59.973-.62.76-.886 1.022c-.296.291-.603.606-.259 1.19s1.529 2.493 3.285 4.039c2.255 1.986 4.158 2.602 4.748 2.894.59.292.935.243 1.279-.146.344-.39 1.476-1.703 1.869-2.286s.787-.487 1.329-.292c.542.194 3.445 1.604 4.035 1.896.59.292.984.438 1.132.681.148.242.148 1.41-.344 2.771z"/></svg>
				</i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--pinterest d-none d-lg-block" data-share-url="http://pinterest.com/pin/create/button/?url=https%3a%2f%2fwww.chabadcoconutcreek.com%2ftemplates%2farticlecco_cdo%2faid%2f281574%2fjewish%2fPrintable-Mail-Form.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dpinterest&amp;description=Printable+Mail+Form+-+Chabad+Lubavitch+of+Coconut+Creek+%26+W+Pompano+Beach+Fl+Florida">
				<i class="fa fa-pinterest"></i>
			</a>
<a class="page-tools__tool" onclick="showEmailLayer(this);">
<i class="fa fa-envelope"></i>
</a>
</div>
<div class="page-tools__section page-tools__section--other js-page-tool-other">
<div class="page-tools__tool popover-parent d-lg-block">
<div class="popover popover--right align_left nowrap">
<div class="popover__content">
<label class="bold bottom_margin block">
Print Options:
</label>
<form class="vcenter" name="print-form" onsubmit="coPrint(event, 281531);return false;">
<div>
<label><input type="checkbox" name="print-green"><span title="Save paper and ink">Print without images <i class="fa fa-leaf text-green"></i></span></label>
</div>
<br/>
<div class="center">
<button class="co-button page-tools__print-button">Print</button>
</div>
</form>
</div>
</div>
<i class="fa fa-print"></i>
</div>
</div>
</div>
<div class="js-fab-wrapper fab-wrapper">
<div class="fab">
<i class="fab-icon"></i>
</div>
</div>
</aside>
<!-- END CACHE -->
	</div>

				<div class="break_floats"></div>
			</div>
		</div>
	</div>
	<div id="footer">
		
	

		<div class="wrapper body_container">
			
				<div class="g960 footer_family_text bottom_padding">
					
		<div class="footer_container footer_text copyright_text">
			<div class="bottom_padding clear_float">
				<img class="footer_hr" src="https://w2.chabad.org/images/global/spacer.gif" vspace="12" width="100%" height="1" /><br />
				
				<div class="footer_inner_container clearfix">
					

					



	<div class="footer3">
		<span class="footer-title" >Chabad Lubavitch of Coconut Creek & W Pompano Beach Fl Florida</span>
		<div class="footer-address">
			<span class="footer-street">4640 NW 74th Place </span>
			<span class="footer-city-state">Coconut Creek, FL 33073-3549</span>
		</div>
			<span>954-422-1987</span>
	</div>
	<img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="6" border="0" /><br />



Powered by <a href="https://www.chabad.org/" target="_new" class="">Chabad.org</a> &copy; 1993-2026 <a href="/4026210" target="_blank" class="privacy-link">Privacy Policy</a>




					
				</div>
			</div>
		</div>
	
				</div>
			
		</div>
	</div>

	
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/os/jquery-latest.min.js?v=0293E3EC"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/co/dist/CoLib.js?v=F809B22F"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/WebComponents/bundles/magen-cdo-global.js?v=95D39855"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/templates/sites6.js?v=E04072E1"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/primarynavigation.js?v=76ABCD73"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/BetaFeedback.js?v=D421ABC8"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/multimedia/infolayer.js?v=ED1B8531"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/commentsloader.js?v=AD6AAB79"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/subscribeprompt.js?v=86D84DC2"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/modules/pagetools.js?v=930B07AB"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/deprecated.js?v=D506A83E"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/OverrideJSDocumentWrite.js?v=9A0227AA"></script><script>$j = $j.fn ? $j : jQuery;$j(()=>{$q.forEach(f=>{try{f.call(window);}catch(ex){console.error(ex);}});})</script>
	

<script  language="javascript" type="text/javascript"> Co.Settings      = {CacheClassName:'js-cache-default',MosadName:'Chabad Lubavitch of Coconut Creek & W Pompano Beach Fl Florida'}; Co.ArticleId     = '281574';Co.SectionId     = 281531;Co.PartnerSiteId = 0;Co.SiteId        = 178;Co.IsMobilePage  = false;Co.IsResponsive  = false;Co.DbDomain      = 'ChabadCoconutCreek.com';Co.LanguageCode  = '';Co.LoginStatus   = 'None';</script>

    
</body>
</html>