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[[preprinted form]]
TENTH ANNIVERSARY CAMPAIGN

To the

Office No. [[line]]

Federation for the Support of Jewish Philanthropic Societies of New York City

Date [[line]]

I hearby agree-in accordance with the terms on the back hereof-
to subscribe to the sum of [[line]] dollars for the year [[strikethrough]] 1926 [[/strikethrough]] ^[[1928]] and annually thereafter.

Name [[line]]
Address [[line]]
Firm name [[line]]
Business Address [[line]]
Industry or Profession [[line]]
Secured by [[line]]

Make checks payable to
H. A. GUINZBURG, Treasurer, 114 Fifth Avenue, NEW YORK CITY
[[/preprinted form]]