Online Membership Form -- Part II

Rebecca Level

Please fill out the information below and then click on the button marked "Proceed to Payment":
Name*:

Address*:

City*:      State*:    Zip*:

Phone (with area code)*:

E-mail (IMPORTANT)*:

(optional) This is a GIFT membership, donated by:

My choice of gift number 1:
     A book chosen by Rabbi August
     A custom Lev Eisha heart keychain
     The Lev Eisha CD: Shabbat Songs from a Woman's Heart
     The Lev Eisha Haggadah: Journey of the Heart
     The Lev Eisha Pesach Cookbook: Passover Recipes from the Heart
     I don't want a first gift

My choice of gift number 2:
     A book chosen by Rabbi August
     A custom Lev Eisha heart keychain
     The Lev Eisha CD: Shabbat Songs from a Woman's Heart
     The Lev Eisha Haggadah: Journey of the Heart
     The Lev Eisha Pesach Cookbook: Passover Recipes from the Heart
     I don't want a second gift

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If you have any questions, please e-mail the Membership Chair.

Lev Eisha--A joyous community of Jewish women engaged in prayer, study and spiritual growth

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