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To apply for a Shluchim gemach, please provide your the information requested below.

Personal Information


First Name

Last Name


Address

City

ST

Zip

Work Phone

Home Phone

Mobile

Email

Regional Shliach
Bold items required.

WEDDINGS

Loan conditions:

  • Loan will be repaid in monthly installments over two years
  • Payment installments will be made with head checks from a U.S. bank along with a credit card
  • Loan will provide up to a maximum sum of $5,000.00.

When is your child’s Wedding?
Where will the wedding be held?

City

State

Zip/PostalCode

Country

Chosson's full name

Kallah's full name
What is your official title and/or position?
Do you receive a fixed salary from another shliach? Yes No
If YES, please provide his name:
 
Apply for a Gemach