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Partnership

Partnership

PARTNERSHIP INFORMATION

THE ROK FAMILY SHUL

CHABAD DOWNTOWN JEWISH CENTER

 

SECTION I:  YOUR INFO

 

SECTION II:  SPOUSE'S INFO

 Name

 

 Name

 Hebrew Name    Hebrew Name
 Father's Hebrew  
 Name
   Father's Hebrew  
 Name
 Mother's Hebrew 
 Name
   Mother's Hebrew 
 Name
 Occupation    Occupation
 Birth Date  /   /  
MM / DD / YYYY format
   Birth Date  /   /  
MM / DD / YYYY format
 Jewish by:   Birth      Converted    Jewish by:    Birth       Converted
 Check One:   Cohen   Levi    Israel    Check One:   Cohen   Levi   Israel

 

SECTION III:  PERSONAL INFORMATION

 Address   Email 1
 City/State/Zip  /  /    Email 2
 Home Phone   Marital Status
 Work Phone   Anniversary Date  /   /  
MM / DD / YYYY format
 Work Fax   If Divorced: Do you have a 
Jewish "Get" ?   Yes    No

 

SECTION IV: CHILDREN

 Name

 

 Birth Date

 /   /  
MM / DD / YYYY format

 Name

 

 Birth Date

 /   /  
MM / DD / YYYY format

 Name

 

 Birth Date

 /   /  
MM / DD / YYYY format

 Name

 

 Birth Date

 /   /  
MM / DD / YYYY format

 Name

 

 Birth Date

 /   /  
MM / DD / YYYY format

 Name

 

 Birth Date

 /   /  
MM / DD / YYYY format
 Are any children adopted?  Yes   No    If yes, give details, including any coversion info:
  

 

SECTION V: YAHRZEIT INFORMATION

 Name

 
English / Hebrew / Father's Hebrew / Last

 

 /   /   
Date of Passing: MM / DD / YYYY
Relationship

 Name

 
English / Hebrew / Father's Hebrew / Last

 

 /   /   
Date of Passing: MM / DD / YYYY
Relationship

 Name

 
English / Hebrew / Father's Hebrew / Last

 

 /   /   
Date of Passing: MM / DD / YYYY
Relationship

 Name

 
English / Hebrew / Father's Hebrew / Last

 

 /   /   
Date of Passing: MM / DD / YYYY
Relationship

 Name

 
English / Hebrew / Father's Hebrew / Last

 

 /   /   
Date of Passing: MM / DD / YYYY
Relationship

 Name

 
English / Hebrew / Father's Hebrew / Last

 

 /   /   
Date of Passing: MM / DD / YYYY
Relationship

 

SECTION VI: PARTNERSHIP OPPORTUNITIES
In our effort to be inclusive for families of all income levels, Partnership Opportunities have been designed within a wide range. However, if you are capable, please consider participating at a higher level. This will allow us to cover our expenses and continue to expand our programs, services and long term goals. All Partnership gifts can be made in one installment or in 12 monthly installments. Please check the option of your choice. Nobody will be turned away due to lack of funds.
  Founder $2,000 Monthly - $24,000 Yearly
  Platinum Partnership $1,000 Monthly - $12,000 Yearly
  Gold Partnership $500 Monthly - $6,000 Yearly
  Silver Partnership $360 Monthly - $4,320 Yearly
  Bronze Partnership $250 Monthly - $3,000 Yearly
  Chai Partnership $150 Monthly - $1,800 Yearly
  Family Partnership $125  Monthly - $1,500 Yearly
  Associate Partnership $54  Monthly - $648 Yearly

 

SECTION VII: PAYMENT INFORMATION
  Payment Method: Card #:
  Exp. Date   CVV Code:
  Optional Comments:  I wish to pay the full annual donation 
 I wish to pay 12 Month Installments
 
You will be charged at the beginning of each month.
 
Begin payments on:  
 Other: 
       
   

TOTALS: 

 

    Partnership Total Amount:

    Total Amount to be charged today:


* All contributions are tax deductible and can be paid throughout the year. No one is turned away for lack of funds. If you cannot afford the full amount requested, contact the Rabbi Chaim LIpskar for a confidential agreement.

 

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