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Sample: Assistance Response Form

NATIONAL DONOR SABBATH
ASSISTANCE FORM
FOR COMPLETION BY SYNAGOGUE

PLEASE RETURN TO: TRANSPLANT FOR LIFE AS SOON AS POSSIBLE
P.O. BOX 261127, Encino, CA 91436 Telephone: (818) 879-7799 Fax: (818) 986-5576

Please Print

Name of Congregation:____________________________________________________
Clergy:___________________________ Executive Director: __________________________
Name of your Contact Person: __________________________________________________________
Telephone: ____________________ Fax: ___________________ E-Mail: __________________

Prior to our PRIORITY FAX, was your congregation aware of National Donor Sabbath? Yes No

How does your congregation plan on including "NATIONAL DONOR SABBATH" IN YOUR SABBATH SERVICE? Please (X) check all that apply. Also indicate any other educational material you need i.e. sample sermons, bulletin inserts, brochures with donor cards (indicate amount needed).

Give a sermon Refer to organ / tissue in Bulletin
Sample Bulletin Announcements Distribute donor cards (Amount:____)
Telephone Committee Use relevant scripture
Invite a Speaker Other - Please specify below:




Would you want TRANSPLANT FOR LIFE to assist you with preparing media stories generated in response to your participation in National Donor Sabbath? Yes No
If so, please specify the type of media coverage you are interested in receiving.
T.V. Radio Newspaper Religious Press Other: (Please explain)

Your Comments:




Bless you and all members of your congregation for helping to make "Miracles through Understanding United" occur at your House of Worship and help save many lives that would otherwise be lost.
Transplant For Life