Online Donation Use this form to make an online donation. If this is for something specific, please note that in the comment box Donor information Campaign Hadassah-Israel First Name* Last Name* Organization Address* City* Zip State Country* Select Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Canary Islands Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-bissau Guyana Haiti Heard and Mc Donald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka St. Barthelemy St. Eustatius St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand The Democratic Republic of Congo Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Zambia Zimbabwe Phone* Email* Credit my donation to: --Select-- General Chapter Bat Yam – Ner Halaila Chapter Hadera – Horshat Ha'Eucalyptus Chapter Jerusalem – Rakefet Chapter Jerusalem – Yakinton Chapter Karmiel – Lilach Chapter Modiin – Mor Chapter Netanya – Shoshana Chapter Petach Tikva – Rotem Chapter Raanana / Hasharon Area – Iris Chapter Rehovot – Shaked Chapter Rishon LeTzion – Sachlev Chapter Tel Aviv – Shoshan Tzachor Chapter Beer Sheva – Eshel Chapter Haifa – Oren Chapter Jerusalem – Nachama Chapter Jerusalem – Tamar Chapter Modiin – Levonah Chapter Netanya – Hadar Chapter Raanana / Sharon Area – Vered Hasharon Donation Designation --Select-- General Walkathon Hadassah Hospital Rehabilitation Department Women at Risk Child at Risk Comment Donation Information Donation type Onetime Recurring Frequency --Select-- Daily Weekly Monthly Quarterly Semi-Annually Number occurrences Amount ₪ 18.00 ₪ 36.00 ₪ 50.00 ₪ 100.00 ₪ 180.00 ₪ Currency Select currency U.S. Dollars Israeli Shekel Payment method * Paypal / Credit Card Offline Payment Zipcode* Credit Card Number* Expiration Date* 01 02 03 04 05 06 07 08 09 10 11 12 / 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 Card (CVV) Code* Card type* Visa MasterCard Discover American Express Card Holder Name* FOR ANY PROBLEMS WITH PAYMENT PLEASE CONTACT THE HADASSAH-ISRAEL OFFICE AT OR BY TEL.:02-6231411 OR 02-6236125 Thank you!
