The HIAS Foundation Planned Giving

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Unfortunately, javascript is not enabled on your browser and this feature will not work</p> </noscript> <h1>Contact Us</h1> <p>Jonathan Boiskin<br />Executive Director<br />301-844-7900<br /><a title="Email Jonathan Boiskin" href="mailto:jonathan.boiskin@hiasfoundation.org">jonathan.boiskin@hiasfoundation.org </a></p> <p>The HIAS Foundation<br />1300 Spring Street, Suite 500<br />Silver Spring, MD 20910<br />Federal Tax ID Number: 87-4477821</p> <p> </p><form name='form' method="post" action="index.php?cID=142"> <input name="sender" value="noreply@hiasfoundation.giftplans.org" type="hidden" /> <input name="recipient" value="jonathan.boiskin@hiasfoundation.org,brieana.taylor@hiasfoundation.org" type="hidden" /> <input name="subject" value="the HIAS Foundation Planned Giving Contact Request" type="hidden" /> <input name="type" value="long" type="hidden" /> <table border="0" cellpadding="0" cellspacing="2" style="width:100%; max-width:500px;" class="contact-form"> <tbody> <tr> <td width="160"><span style="color: #e31c3d;">*</span> <label for="realname">Name:</label></td> <td><input name="realname" style="width:100%;" type="text" id="realname" title="realname"></td> </tr> <tr> <td>   <label for="occupation">Occupation:</label></td> <td><input name="occupation" type="text" style="width:100%;" title="occupation" id="occupation"></td> </tr> <tr> <td>   <label for="age">Age:</label></td> <td><input name="age" style="width:100%;" type="text" title="age" id="age" /></td> </tr> <tr> <td>   <label for="address">Address:</label></td> <td><input name="address" style="width:100%;" type="text" title="address" id="address"></td> </tr> <tr> <td>   <label for="city">City:</label></td> <td><input name="city" style="width:100%;" type="text" title="city" id="city"></td> </tr> <tr> <td>   <label for="state">State/Province:</label></td> <td><input name="state" style="width:100%;" type="text" title="state" id="state"></td> </tr> <tr> <td>   <label for="zip">Postal Code:</label></td> <td><input name="zip" style="width:100%;" type="text" title="zip" id="zip"></td> </tr> <tr> <td>   <label for="country">Country:</label></td> <td><input name="country" style="width:100%;" type="text" title="country" id="country"></td> </tr> <tr> <td>   <label for="phone">Phone:</label></td> <td><input name="phone" style="width:100%;" type="text" title="phone" id="phone"></td> </tr> <tr> <td><span class="required" style="color: #e31c3d;">*</span> <label for="email">E-mail:</label></td> <td><input name="email" style="width:100%;" type="text" title="email" id="email"></td> </tr> </tbody> </table> <br /> <table border="0" cellspacing="0" cellpadding="0" style="width:100%; max-width:500px;"> <tr> <td colspan="2"> <hr> <p style="margin-top:0;">I would like more information on planned giving at <script type="text/javascript">document.write(orgName);</script>:</p> </td> </tr> <tr> <td width="37%" align="right" valign="top"><input name="callme" type="checkbox" id="callme" value="Phone" title=""/></td> <td width="63%" valign="top"> <label for="callme">Please call me</label></td> </tr> <tr> <td align="right" valign="top"><input name="emailme" type="checkbox" id="emailme" value="E-Mail" title=""/></td> <td valign="top"> <label for="emailme">Please e-mail me</label></td> </tr> <tr> <td align="right" valign="top"><input name="bookletme" type="checkbox" id="bookletme" value="Send eBrochure" title=""/></td> <td valign="top"> <label for="bookletme">Please send me an eBrochure</label></td> </tr> </table> <table width="100%" border="0" cellspacing="0" cellpadding="0" style="width:100%; max-width:500px;"> <tr> <td colspan="2"> <hr> <p>Please be sure I am on the mailing list to receive <script type="text/javascript">document.write(orgName);</script> planned giving newsletter.</p> </td> </tr> <tr> <td width="37%" align="right"><input type="radio" name="newsletter" value="Yes" id="newsletteryes" /></td> <td width="63%"> <label for="newsletteryes">Yes</label></td> </tr> <tr> <td align="right"><input type="radio" name="newsletter" value="No" id="newsletterno" /></td> <td> <label for="newsletterno">No</label></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> </table> <p> <label for="comments">Questions or Comments:</label> <br> <textarea rows="6" name="comments" cols="31" id="comments" style="width:100%; max-width:500px;"></textarea> </p> <p> <div id="reaptcha" class="g-recaptcha" data-sitekey="6LeYxiEpAAAAANlPLlhLw4oohmjZClLPI1vLAgnq" data-callback="enableBtn"></div><br> <input id="submitButton" type='button' value="Submit" onclick="verify();" title=""> <input type='reset' value="Clear Form" title=""> </p> <p style="color: #e31c3d;">*All fields marked with the asterisk symbol (*) are required.</p> <input type="text" name="hp_homepage" id="pentera_hpc" title="Honeypot"/> </form> <p class="pentback"><a href="javascript:history.go(-1);">Back</a></p> <p class="pentcopy">© Pentera, Inc. 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