The Shamir Friends Association

Timeless Fund

Personal Information

* First Name

* Last Name

* Mobile

* Email Address

I approve sending verifications, instructions and other messages to the email address I have provided.

Donation for Life Saving Equipment

* The Sum You Wish to Donate

Sum for Donation

* Donation Purpose

Please Specify

Payment

Total Amount

$ 0.00

* Payment Method

I agree to make out a check

* Institute Name

* Institute Number

* Institute's accounting contact

* Institute's accounting phone

* Institute's billing address

I agree to make a bank transfer of the aforementioned amount

After submitting the form you will be redirected to PayPal to confirm the transaction. Only after doing so your registration will be completed.

Invitation code

In order to verify that you were invited, please fill in the code you recieved when invited