Annual Giving Form Annual Giving Worksheet July 2021 - June 2022 Name* First Last Email* Enter Email Confirm Email Phone*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Choose your giving level - either A-1 or A-2A-1- Standard Giving (includes High Holiday tickets)Couple (33-67)$3,300 Price: $3,300.00 Quantity: Single (33-67)$1,700 Price: $1,700.00 Quantity: Older Adult Couple (68 and over)$1,800 Price: $1,800.00 Quantity: Older Adult Single (68 and over)$1,200 Price: $1,200.00 Quantity: Young Couple (32 and under)$360 Price: $360.00 Quantity: Young Single (32 and under)$180 Price: $180.00 Quantity: Sharon Member's Annual Fee$450 Price: $450.00 Quantity: Friend of CBIFor those who belong to another synagogue and wish to stay connected to CBI. High Holiday tickets not included Price: $360.00 Quantity: A-2- Benefactor (includes High Holiday and recognition events)Platinum Chai (Gala Full Table/enrichment fund patron) Price: $18,000.00 Quantity: Golden Chai (6 gala seats/enrichment fund patron) Price: $10,690.00 Quantity: Silver Chai (4 gala seats) Price: $7,672.00 Quantity: Bronze Chai (2 gala seats) Price: $5,754.00 Quantity: Copper Chai Price: $3,836.00 Quantity: B- Program SustenanceMembership Support Fund (discretionary amount)Supports fellow congregants unable to meet the full dues commitment Security Fund (discretionary amount)Additional money to help fund CBI's security needs CBI Coastal ServiceSupports participatory, lay-led Shabbat programming in the Irvine/Newport Beach area Price: $360.00 Quantity: Youth Shabbat Programming (discretionary amount)Supports youth Shabbat programming Adult Enrichment-per personSupports additional educational, cultural, musical, and religious speakers and experiences Price: $500.00 Quantity: C-Education Fees Kindergarten, Alef (1st) Price: $625.00 Quantity: Bet-Zayin (2nd-7th)Supports additional educational, cultural, musical, and religious speakers and experiences Price: $1,045.00 Quantity: Family Class Supplement (6th & 7th)/per familyLife Cycle class tuition for students in Jewish Day School not enrolled in CBI Religious School Price: $180.00 Quantity: Hebrew High (8th-12th) Price: $625.00 Quantity: Religious School PTO ($36/family) Price: $36.00 Quantity: D-Affiliate Programs Women's Club Price: $36.00 Quantity: Men's Club Price: $36.00 Quantity: Machar (K-3rd) Price: $25.00 Quantity: Kadima (4th-6th) Price: $75.00 Quantity: USY (7th-12th) Price: $100.00 Quantity: Comments (optional)Payment InformationTotal Payment Method* 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 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Comments (optional)
