Annual Giving Form Annual Giving Worksheet 2022/2023 July 2022 - June 2023 Name* First Last Email* Enter Email Confirm Email Phone*Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code A. Choose your Membership Giving Level - Either Standard or BenefactorA1. Standard Annual Giving LevelsAll but "Friend of CBI" include High Holy Day tickets.Couple (age 36-67) Price: $3,375.00 Quantity: Individual (age 36-67) Price: $1,750.00 Quantity: Couple (age 68 and over) Price: $1,900.00 Quantity: Individual (age 68 and over) Price: $1,200.00 Quantity: Couple (age 35 and under) Price: $360.00 Quantity: Individual (age 35 and under) Price: $180.00 Quantity: Sharon Members' Annual Fee Price: $500.00 Quantity: Friend of CBIFor those with membership at other synagogues. Does not include High Holy Day tickets. Price: $360.00 Quantity: A2. Annual Benefactor LevelsIncludes High Holy Day tickets and Recognition EventsPlatinum Chai (Gala Full Table/Adult Enrichment Patron) Price: $18,000.00 Quantity: Golden Chai (6 Gala seats/Adult Enrichment Patron) Price: $10,800.00 Quantity: Silver Chai (4 Gala seats) Price: $7,750.00 Quantity: Bronze Chai (2 Gala seats) Price: $5,825.00 Quantity: Copper Chai (Gala seats not included) Price: $3,900.00 Quantity: B. Mandatory Security Fee:Couple Price: $100.00 Quantity: Individual Price: $50.00 Quantity: C. Choose Additional SupportMembership Support Fund (enter discretionary amount)Helps offset fees of those members needing financial assistance Security Fund (enter discretionary amount)Additional money to help fund CBI's security needs Youth Shabbat Programming (enter discretionary amount)Including Junior Congregation CBI Coastal ServiceShabbat morning programming in Irvine Price: $360.00 Quantity: Adult Enrichment Patron ($500/person)Supports additional educational, cultural, musical, and religious speakers and experiences Price: $500.00 Quantity: D. Education Fees Alef (K-1st) Price: $650.00 Quantity: Bet-Zayin (2nd-7th) Price: $1,085.00 Quantity: Hebrew High (8th-12th) Price: $650.00 Quantity: Family Class Supplement (6th & 7th)/per familyRequired for B’nai Mitzvah pupils not enrolled in CBI Religious School Price: $180.00 Quantity: Religious School PTO ($36/family) Price: $36.00 Quantity: E. Youth Groups and Affiliate Programs Youth Registration Formhttps://docs.google.com/forms/d/1TuDNPv_YguxVMN02F2Vs2_ZEYsCAMabK3xpyhYOEp38/edithttps://www.cbi18.org/wp-admin/admin.php?page=gf_edit_forms&id=248https://www.cbi18.org/wp-admin/admin.php?page=gf_edit_forms&id=248 Machar (K-3rd) Price: $25.00 Quantity: Kadima (4th-6th) Price: $75.00 Quantity: USY (7th-12th) Price: $100.00 Quantity: Women's Club Price: $36.00 Quantity: Men's Club Price: $36.00 Quantity: Comments (optional)F. Payment InformationPayments towards 2022-2023 ANNUAL GIVING, DONATIONS, AND OTHER FEES must begin by end of July 2022 to guarantee High Holy Day tickets and religious school enrollment.Total $0.00 Payment Method*I agree to adhere to the Congregation B’nai Israel by-laws and monetary obligations. I understand that my past ANNUAL GIVING, DONATIONS, AND OTHER FEES are now due. If I am unable to fulfill my financial obligations to CBI, I will contact the Executive Director (exdir@cbi18.org) NEW! To help CBI save CC processing fees, I will contact the office for information to pay by ACH Continue my monthly payment plan I will send a check(s) to the CBI office, see comments below for my payment plan Charge my card on file for the full amount I will pay in full online now with my Visa or MasterCard I will contact the office to set up a payment plan Please see comments below for my payment plan Credit Card MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Security Code Cardholder Name Comments (optional)
