Partnership-Membership - Chabad of Pinellas County

Name Your Own Price Membership

Feel Free to Pay Whatever You Like! Here Are Some Suggestions:
* All levels below will receive recognition on our website
* Any Membership Gift includes two High Holiday Seats

Pick One*

$54 per month/ $648 per yr. - Name on Chai Friends Board$72 per month/ $864 per yr. - All of the Above Plus Special Donor Appreciation$100 per month / $1200 per yr - All of the Above Plus a Mezuzah$136 per month / $1632 per yr. - All of the Above Plus a Box of Shmurah Matzah$180 per month / $2160 per yr. - All of the Above Plus one KiddushBe a Pillar of YIChabad for just $18x18 = $324 a month ($3,888 yr.)! This includes a plaque on the Memorial Board or two plaques on the Tree of Life

Please Choose From The Following Payment Plans*

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Payment*

Credit Card Check

Postal / Zip Code

Country

Full Name*

First NameLast Name

Hebrew Name

Jewishness

From BirthConvertNot Jewish

Family

KohenLeviYisroel

Occupation

Cell Number

Area CodePhone Number

Work Number

Area CodePhone Number

Home Number

Area CodePhone Number

Birth Date

MonthDayYear

Before or After Sunset

For Hebrew Date Calculation

Marital Status

Anniversary Date

MonthDayYear

E-mail*

Full Name

First NameLast Name

Hebrew Name

Jewishness

From BirthConvertNot Jewish

Family

KohenLeviYisroel

Occupation

Cell Number

Area CodePhone Number

Work Number

Area CodePhone Number

Home Number

Area CodePhone Number

Birth Date

MonthDayYear

Before or After Sunset

E-mail

Father

MonthDayYear

Before or After Sunset

Mother

MonthDayYear

Before or After Sunset

Father of Spouse

MonthDayYear

Before or After Sunset

Mother of Spouse

MonthDayYear

Before or After Sunset

Full Name

First NameLast Name

Birth Date

MonthDayYear

Before or After Sunset

Full Name

First NameLast Name

Birth Date

MonthDayYear

Before or After Sunset

Full Name

First NameLast Name

Birth Date

MonthDayYear

Before or After Sunset

Full Name

First NameLast Name

Birth Date

MonthDayYear

Before or After Sunset

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Partnership-Membership Form

PERSONAL INFORMATION

Spouse (If Applicable)

YAHRTZEITS

CHILDREN (If Applicable)