2020-2021 Membership Renewal – Annual Giving and Support Worksheet 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$3,315 Price: $3,315.00 Quantity: Single$1,695 Price: $1,695.00 Quantity: Older Adult Couple (65 and over)$1,695 Price: $1,695.00 Quantity: Older Adult Single (65 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 Facility Maintenance (for Sharon members only)$450 Price: $450.00 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: Double Chai Price: $3,836.00 Quantity: B- Program SustenanceMembership Support Fund (discretionary amount)Supports fellow congregants unable to meet the full dues commitment NEW: 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: Jr Congregation (discretionary amount)Supports youth Shabbat programming 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: Adult EnrichmentSupports additional educational, cultural, musical, and religious speakers and experiences Price: $500.00 Quantity: C-Education Fees Kindergarten, Alef (1st) Price: $585.00 Quantity: Bet-Zayin (2nd-7th)Supports additional educational, cultural, musical, and religious speakers and experiences Price: $985.00 Quantity: Family Class Supplement (6th & 7th)Life Cycle class tuition for students in Jewish Day School not enrolled in CBI Religious School Price: $180.00 Quantity: Hebrew High (8th-12th) Price: $575.00 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: Religious School PTO ($36/family) Price: $36.00 Quantity: Comments (optional)Payment InformationTotal $0.00 Payment Method*Charge my card on file for the full amountCharge my card on file for 1/3 of dues and the balance monthlyI will send a check(s) to the CBI officeI will pay in full online now with my Visa or MasterCardI will contact the office to set up a payment planCredit Card MasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Comments (optional)