Midwest Benefit Alternate Payment Form

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Click Here to Sponsor the Midwest Benefit.
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Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email*

Cell Phone*

My gift will be made by:*

Donor Advised Fund
Check
Zelle
Stock Transfer
International Currency

Our Sharsheret TAX ID is 13-4198529

Your donation will help support Sharsheret's programs and services:*

Take advantage of Additional Benefits:
*With a donation of $5,000 and above, we welcome you to Sharsheret’s exclusive Jewel Circle. Learn more at Sharsheret.org/jewelcircle
All gifts of $750 or more received before March 4, 2026 will be recognized in the program listing.
Contributions excluding the ticket value of $100 per person are tax-deductible.

I am attending:*

Yes
No

Number of Attendees*

First Name of Attendee #1

Last Name of Attendee #1

First Name of Attendee #2

Last Name of Attendee #2

First Name of Attendee #3

Last Name of Attendee #3

First Name of Attendee #4

Last Name of Attendee #4

Additional Names of Attendees

Please list my name in the program as (For gifts of $750 or more):

My contribution is in honor of:

Dr. Carol Ellman, Maimonides Award Recipient

My contribution is in honor of:

Sari Winick, Woman of Valor

My contribution is in honor of:

Ariela Robinson, Guest of Honor

Sharsheret's Founder Rochelle Shoretz, A''H

My donation is in memory of Sharsheret Founder Rochelle Shoretz A”H.

Employer's Matching Gift & Legacy Giving Program

My gift will be matched by my employer’s matching gift program.
I am interested in learning more about Sharsheret’s Legacy Giving program.

Midwest Benefit Alternate Payment Form

Midwest Benefit 2026