* Required

Thank you for supporting PJA through the Tribute of your choice. Please fill out the form below as completely as you can. Call Lisa Katon, Donor Relations & Grants Specialist at 503.535.3532 with any questions or concerns. Thanks again!

Full Name or Company Name*required

Address

City

State/Province

Zip/Postal Code

Country

Home Phone*required

Cell Phone*required

Please enter your preferred email address:

How are you related to PJA?

Alumnus/Alumna Former PJA Parent Current PJA Parent Former PJA Grandparent Current PJA Grandparent Friend of PJA Other

If you selected "Other", please explain:

Yes, I/We want to help PJA! Please use my/our contribution for the following fund:

PJA Annual Fund/General Operations Harry & Diane Nemer Endowment Fund Eighth Grade Israel Trip Atid Fund Artist-in-Residence Harriette Shain Library Fund Helen Chaiken Blum Library Fund Scholarship Fund Technology Fund Music Fund Lisa Metsker Memorial Fund Noam Stampfer Gemilut Chasadim Fund

My Donation Amount

Total Donation

I/We are giving this gift in Memory of:

I/We are giving this gift in Honor of:

Please send Get Well wishes to:

Please send an acknowledgement to (please enter name and mailing address):

May we acknowledge your generosity in our printed or online publications?

Yes, please No, thank you

Please enter your name(s) here however you would like it to appear in that acknowledgement:

May we send you email updates from PJA from time to time?

Yes, please No, thank you

Hitting the SUBMIT button below will take you to our secure payment page.

THANK YOU so much for your generosity and support of PJA!

Please send a confirmation email to the address below*:

Please provide an email address where we can send a link to your current form.
Email Address :