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Please make checks payable to:

KBY Cogregations Together, Inc.
PO Box 23170
Brooklyn, NY 11202

Contributor Contact Information

Full Name:

Address Line 1:

Address Line 2:

City, State, Zip:

Telephone:

Email:

Contribution

[ ] KBY Associate ($360); [ ] KBY Friend ($180); [ ] Other: _________

Direct my contribution to a(n):
                       [ ] Reform Congregation
                      [ ] Conservative Congregation
                      [ ] Unaffiliated Progressive Congregation
                      [ ] Specific Congregation
                                 [ please specify: _______________________ ]

Specific Requests or Instructions:

___________________________________________________________________

KBY's charitable, tax-exemption application has been approved by the Internal Revenue Service. KBY contributions are tax-deductible, to the fullest extent permitted by U.S. tax laws.