Approved

Name:

Amount:

Card Type:

Card Number:

Authcode:

AVS Result:

CVV Result:

OK

Donation Details

Choose Option

$25,000 - Marbitz Torah

$18,000 - Machazik Torah

$10,000 - Sarei Asarah

$5,000 - Sponsor

$2,500 - Parnes Hayom

$1,800 - Diamond Page

$1,000 - Gold Page

$750 - Silver Page

$500 - Full Page

$360 - Half Page

$250 - Third Page

$150 - Quarter Page

Silver page or above entitles you to 2 dinner reservations

Amount:

In honor of

Rabbi and Rebbetzin
Yussie Zakutinsky

Mr. and Mrs.
Yoel Gross

Journal Ad

Pay in Installments

2 Months 3 Months 4 Months 5 Months 6 Months 8 Months 10 Months 12 Months 18 Months 24 Months 36 Months

Personal Information

Name ^*

Street Address ^*

Zip code ^*

Phone Number ^*

Email Address ^*

Credit Card Details

Pay with Check

Card Number ^*

MMYY ^*

CVV

?

Process Payment

Processing By

Merch Pay, Inc. is a registered ISO of Wells Fargo Bank, N.A., Concord, CA.

merchant login merchant login merchant login merchant login

Credit & Debit Processing | Electronic Check Services | Gift & Loyalty Programs | Customized POS Solutions

Bais Yaakov Ateres Miriam

1214 Heyson Road
Far Rockaway, NY 11691

Tell: 718-868-3232

[response]

ID #[transid]

[created]

[cardholder]

$ [amount]

[cardtype]   [ccnum4]

Authorization Number

[authcode]

AVS Response

[avsresult]

CVV response

[cvcresult]

[otherTransaction]

Thank you for your payment.