Beth Israel Congregation Prayer Book Form

Please print out this form, and send with your contribution to:

Beth Israel Congregation
2000 Washtenaw
Ann Arbor, MI 48104.

� Please find enclosed my donation of $36 to the Beth Israel Prayer Book Fund.

Name of Contributor_________________________________________________________________________

Address___________________________________________________________________________________

City_______________________________________________State_______________Zip_________________

I would like the Book Plate to contain the following information:

Presented To Beth Israel Congregation

By_________________________________________________________________________________

In � Memory of______________________________________________________________________

In � Honor of______________________________________________________________________