street city state zip
Name of business/company/organization
E-mail/fax to send edited journal ad text
E-mail Telephone Fax
Cell phone 1 Cell phone 2
Journal Ads: Diamond page Platinum page Gold page Silver Page page
$7,200 $3,600 $1,800 $1,000 $720
Full page Half page Quarter page
$360 $250 $180
Journal Ad Text:
Ad deadline: Erev Rosh Hashanah, September 8, 2010 Note:
1. We will try to email or fax a ﬁnal draft of your ad text for conﬁrmation, but we
cannot guarantee this.
Payment Method: 2. We will make an eﬀort to include all ads, even those received after the
Check (payable to Mesila International) deadline. Ads received past the deadline that do not make it into the journal
will be considered a pledge/donation to Mesila unless otherwise speciﬁed.
Card type: Mastercard Visa American Express Other
Card number Expiry
Cardholder name Signature
For oﬃce use:
Please insert my page ad at $ in the Journal.
We would be pleased to attend this event. Please make reservations.
We are unable to attend. We wish to participate with a contribution of $ STG
This form and any related inquiries should be sent to:
Mesila Mesila International, Inc. Mesila UK Canada
P.O.B. 57116, Jerusalem 91570, Israel 1215 40th St., Brooklyn, NY 11218, USA 4 Woodville Court, Woodville Road Gates of Mercy, 32 Brookview Drive
Tel: +972.2.500.0475 • Fax: +972.2.500.0478 Tel: 718.207.5295 • Fax: 718.504.5296 London NW11 9TR, England Toronto, ON M6A 2K2
email@example.com www.mesila.org firstname.lastname@example.org Tel/Fax: +44.20.8209.0043 Tel: 416.780.9069
Reg. Amuta No. 580361236 www.mesilainternational.org email@example.com • www.mesilauk.org Fax: 416.780.9063
Tax ID No. 11-3597720 Reg. Charity No. 1114573
Visit our website at www.mesila.org