Ordered by:

Name: _________________________________________________________________________________________
(enter exactly as it appears on your credit card statement)

Street Address: ________________________________________________________________________________
City: _____________________________________________ State: ___________ Zip Code: ___________________
Phone Number: ___________________________________     Email: _____________________________________

Ship to (if different from above):

Name: ________________________________________________________________________________________
Street Address: _______________________________________________________________________________
City: _______________________________________State: __________________ Zip Code: _________________
How many trees would you like to plant? (check one)
A Single Tree.....$18.00
Ring of Three Trees.....$50.00
Garden of Ten Trees.....$150.00
Chai Garden of Eighteen Trees.....$260.00
Forest of One Hundred Trees.....$1000.00 		Matching Pair of Trees.....$35.00
Circle of Five Trees.....$80.00
Bar/Bat Mitzvah Garden of Thirteen Trees .....$180.00
Grove of Twenty Five Trees.....$350.00

Select your certificate: see samples on Certificate Samples page
Classic      Jerusalem      Tu B' Shevat      Christmas
Information for personalization of tree planting certificate:
1) Select wording:
Tree(s) planted in Israel      Tree(s) planted in the Holy Land

2) Person(s) being honored: __________________________________________________________________
3) Dedication: In Memory      In Honor      In Loving Memory     In Celebration
4) Event: (e.g. Birth, Wedding. Leave blank for In Memorium dedications) ________________________________
5) Planted by: (your name printed on the certificate - optional) _________________________________________
6) Date: (any date - optional) _____________________________________________________________________
Shipping & Handling:
1st Class US Mail · within the U.S. - $1.50     1st Class US Mail · outside the U.S. - $5.00     
Total price: (add your tree cost + shipping cost) $____________________________________________________
Method of payment: (check one) DO NOT SEND CASH!
Check or money order enclosed (payable to Trees for the Holy Land)
Visa      MasterCard      American Express     
Card Number: _________________________________________________ Expiration Date: __________________

Signature of card holder: ______________________________________________________________________
MAIL or FAX along with your payment to:
Trees for the Holy Land    500 Monocacy Blvd    Frederick, MD    21701
Fax orders to:
Trees for the Holy Land    301·695·3632      Questions? Call 301·790·7790