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	Donate - Chabad-Lubavitch of the Shoreline
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High Holiday Appeal</div>
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May you be inscribed & sealed in the Book of Life! Thank you for your generosity!</div>
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              </label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_3_3" name="q3_donationAmount" value="180" />
              <label for="input_3_3"><span>$180 USD</span>
              </label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_3_4" name="q3_donationAmount" value="500" />
              <label for="input_3_4"><span>$500 USD</span>
              </label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_3_5" name="q3_donationAmount" value="1000" />
              <label for="input_3_5"><span>$1000 USD</span>
              </label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_3_6" name="q3_donationAmount" value="1800" />
              <label for="input_3_6"><span>$1800 USD</span>
              </label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_3_7" name="q3_donationAmount" value="5000" />
              <label for="input_3_7"><span>$5000 USD</span>
              </label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio-other form-radio validate[required]" name="q3_donationAmount" id="other_3" value="" /><span><input type="number" class="form-radio-other-input form-textbox" onkeypress="validateNumber(event)" name="q3_donationAmount[other]" data-otherhint="Other" size="15" id="input_3" disabled="disabled" /></span>
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                          <option>  </option>
                          <option value="1"> 1 - January </option>
                          <option value="2"> 2 - February </option>
                          <option value="3"> 3 - March </option>
                          <option value="4"> 4 - April </option>
                          <option value="5"> 5 - May </option>
                          <option value="6"> 6 - June </option>
                          <option value="7"> 7 - July </option>
                          <option value="8"> 8 - August </option>
                          <option value="9"> 9 - September </option>
                          <option value="10"> 10 - October </option>
                          <option value="11"> 11 - November </option>
                          <option value="12"> 12 - December </option>
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                          <option value="2019"> 2019 </option>
                          <option value="2020"> 2020 </option>
                          <option value="2021"> 2021 </option>
                          <option value="2022"> 2022 </option>
                          <option value="2023"> 2023 </option>
                          <option value="2024"> 2024 </option>
                          <option value="2025"> 2025 </option>
                          <option value="2026"> 2026 </option>
                          <option value="2027"> 2027 </option>
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                Please mail check to 800 Village Walk #327, Guilford CT 06437
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