Uniongrams Order Form

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First Name

Last Name

Phone Number

Total Number of Uniongrams

Uniongram #1 Recipient

Uniongram #1 Message

From: Exactly as you want to appear

Uniongram #2 Recipient

Uniongram #2 Message

From: Exactly as you want to appear

Uniongram #3 Recipient

Uniongram #3 Message

From: Exactly as you want to appear

Uniongram #4 Recipient

Uniongram #4 Message

From: Exactly as you want to appear

Uniongram #5 Recipient

Uniongram #5 Message

From: Exactly as you want to appear

Uniongram #6 Recipient

Uniongram #6 Message

From: Exactly as you want to appear

Uniongram #7 Recipient

Uniongram #7 Message

From: Exactly as you want to appear

Uniongram #8 Recipient

Uniongram #8 Message

From: Exactly as you want to appear

Uniongram #9 Recipient

Uniongram #9 Message

From: Exactly as you want to appear

Uniongram #10 Recipient

Uniongram #10 Message

From: Exactly as you want to appear

Uniongram #11 Recipient

Uniongram #11 Message

From: Exactly as you want to appear

Uniongram #12 Recipient

Uniongram #12 Message

From: Exactly as you want to appear

Additional Donation Amount

Total

Notes

You can choose to pay by ACH for no additional fee.

To pay for Uniongrams by check, please make checks payable to:

OST UNIONGRAM FUND

Mail to:
Ohef Sholom Temple
℅ Mara Bates
530 Raleigh Avenue
Norfolk, VA 23507

Mon, January 20 2025 20 Tevet 5785

Ohef Sholom Temple * 530 Raleigh Avenue * Norfolk, VA 23507

757-625-4295

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