Annual Partnership 5782-2021/22

Kindly Indicate Your Preferred Partnership Level.
.5 Share $900.75 Share $1,200 - Friendship Partnership1 Share $1,800 - One Is Hashem Partnership2 Shares $3,600 - Tablet Partnership3 Shares $5,400 - Patriarchs Partnership4 Shares $7,200 - Matriarchs Partnership5 Shares $9,000 - Torah Partnership6 Shares $10,800 - Mishna Partnership7 Shares $12,600 - Universe Partnership10 Shares $18,000 - Commandments Partnership
PARTNER INFO
Full Name*
First NameLast Name
E-mail*
I would like to receive news and updates by email
Hebrew Name
Father's Hebrew Name
Mother's Hebrew Name
Birth Date
MonthDayYear
Born
AMPM
Family
CohenLeviYisroelConvert
Cell Number*
Area CodePhone Number
Home Number
Area CodePhone Number
SPOUSE (IF APPLICABLE)
Full Name
First NameLast Name
Hebrew Name
Father's Hebrew Name
Mother's Hebrew Name
Birth Date
MonthDayYear
Born
AMPM
E-mail
PERSONAL INFORMATION

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Marital Status
Anniversary Date
MonthDayYear
CHILDREN (IF APPLICABLE)
CHILD 1.
Full Name
First NameLast Name
Please check
MaleFemale
Birth Date
MonthDayYear
Born
DayEvening
Child 2.
Full Name
First NameLast Name
Please check
MaleFemale
Birth Date
MonthDayYear
Born
DayEvening
Child 3.
Full Name
First NameLast Name
Please check
MaleFemale
Birth Date
MonthDayYear
Born
DayEvening
Child 4.
Full Name
First NameLast Name
Please check
MaleFemale
Birth Date
MonthDayYear
Born
DayEvening
Yahrtzeit Information & Memorial Plaques
For each entry, please include full English and Hebrew name, family name and relationship. Please check the Yahrzeit. Memorial Plaque check box to reserve a memorial plaque on our beautiful Memorial Board. $1800 Per Plaque. (Monthly Payment Plans Available)
YAHRTZEIT 1.
Full Name
First NameLast Name
Hebrew Name
Relationship
Date of passing
MonthDayYear
Time of Day
AMPM
Yahrzeit Memorial Plaque
$1800.00$0
YAHRTZEIT 2.
Full Name
First NameLast Name
Hebrew Name
Relationship
Date of passing
MonthDayYear
Time of Day
AMPM
Yahrzeit Memorial Plaque
$1800.00$0
YAHRTZEIT 3.
Full Name
First NameLast Name
Hebrew Name
Relationship
Date of passing
MonthDayYear
Time of Day
AMPM
Yahrzeit Memorial Plaque
$1800.00$0
HIGH HOLIDAY SEATS
All Partnership Levels include High Holiday Seats for immediate family members.
Names of Family Members Requiring Seats:
Seat 1.
First NameLast Name
Gender
MaleFemale
High Holiday Seats
Rosh HashanahYom Kippur
Seat 2.
First NameLast Name
Gender
MaleFemale
High Holiday Seats
Rosh HashanahYom Kippur
Seat 3.
First NameLast Name
Gender
MaleFemale
High Holiday Seats
Rosh HashanahYom Kippur
Seat 4.
First NameLast Name
Gender
MaleFemale
High Holiday Seats
Rosh HashanahYom Kippur
Seat 5.
First NameLast Name
Gender
MaleFemale
High Holiday Seats
Rosh HashanahYom Kippur
Seat 6.
First NameLast Name
Gender
MaleFemale
High Holiday Seats
Rosh HashanahYom Kippur
PAYMENT OPTIONS
Please divide my payment to charge card every month:
$
Please charge my partnership in full at this time:
$
Total
$0.00
Yes, I'd like to donate the cost of processing this transaction by adding 3%

Payment*

Credit Card Check

Boca Beach Chabad Legacy Society
Yes! I am including Boca Beach Chabad in my will. All Legacy Society Members will be recognized on our Legacy Society Donor Wall.Yes! Please have a planned giving professional contact me.
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