Name*

Address*

City/Town*

State*

Zip Code*

Email*

Phone*

Sponsoring Rabbi*

Please select five items and rate them (1 being your first choice, 2 your second, and so on), according to what you would like to receive. If you choose tefillin, then that is the only gift you may receive. If you have any questions please contact Debbie Coltin at dcoltin@lappinfoundation.org or 978-740-4428.

Tefillin and tefillin bag

Mezuzah and kosher parchment

Kiddish cup

Tallit and tallit bag

Shabbat/holiday candlesticks

Menorah

Seder plate

Chumash (Bible)

Chumash (Bible) - indicate which one

Prayer book

Prayer book - indicate which one

Other

If you have questions please contact Deborah Coltin at 978-740-4428 or dcoltin@lappinfoundation.org