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LitvakSIG Mail-In Contribution Form
Full Name:
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Address:
 
 
City:
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Postal / Zip code:
Country:
Telephone (Home):
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Please mail your contribution form to:
Eden Joachim
Treasurer
LitvakSIG
41 Country Club Lane
Pomona, NY 10970
USA.

Please accept my contribution of $________ and apply as shown below:

Distict Reserach
District Notes Amount
Disna
Kaunas
Lida
Oshmiany
Panevezys
Raseiniai
Siauliai
Svencionys
Telsiai
Trakai
Ukmerge (Vilkomir)
Vilnius (Vilna)
Zarasai (Novo-Aleksandrovsk)
General Research Fund


Vital Records Translation Project
Shtetl Notes Amount
General


Dues or Donations
Apply Donation To Notes Amount
Internal Passports
Kaunas Family List 1858-1915
Suwalki Gubernia Research Group
General


If paying by Credit Card, please fill out the information below, sign and include with the information above:The form can also be faxed to 845-623-1708
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Signature