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Partner with Chabad of Stamford and help us continue the work we do daily, weekly, monthly and annually in the Stamford Community.

YOUR INFO   SPOUSE'S INFO
Name   Name

Hebrew Name   Hebrew Name
Father's Hebrew
Name
  Father's Hebrew
Name
Mother's Hebrew
Name
  Mother's Hebrew
Name
Occupation   Occupation
Birth Date / /
  Birth Date / /
Check One: Cohen Levi Israel   Check One: Cohen Levi Israel
PERSONAL INFORMATION
Address   Email 1
City/State/Zip / /   Email 2
Home Phone   Marital Status
Work Phone   Anniversary Date / /
Work Fax  
CHILDREN

Name

 

Birth Date

/ /

Name

 

Birth Date

/ /

Name

 

Birth Date

/ /

Name

 

Birth Date

/ /

Name

 

Birth Date

/ /

Name

 

Birth Date

/ /
     
 
YAHRZEIT INFORMATION

Name


  / /
Date of Passing
Relationship

Name


  / /
Date of Passing
Relationship

Name


  / /
Date of Passing
Relationship

Name


  / /
Date of Passing
Relationship

Name


  / /
Date of Passing
Relationship

Name


  / /
Date of Passing
Relationship
P ARTNERSHIP OPPORTUNITIES
In our effort to be inclusive for families of all income levels, Partnership Opportunities have been designed within a wide range. However, if you are capable, please consider participating at a higher level. This will allow us to cover our expenses and continue to expand our programs, services and long term goals. All Partnership gifts can be made in one installment or in 12 monthly installments. Please check the option of your choice. 
 

Partnership

$180 Annual Donation

Associate Partnership $30 Monthly - $360 Yearly

Executive Partnership

$54 Monthly - $648 Yearly

Family Partnership

$72 Monthly - $864 Yearly

Community Partnership

$118 Monthly - $1,416 Yearly

Chai Partnership

$150 Monthly - $1,800 Yearly

Bronze Partnership

$180 Monthly - $2,260 Yearly

Silver Partnership

$250 Monthly - $3,000 Yearly

Gold Partnership

$360 Monthly - $4,320 Yearly

Platinum Partnership

$750 Monthly - $9,000 Yearly

Founder Partnership

$1,000 Monthly - $12,000 Yearly

Other

Please choose the amount you wish to donate (every donation makes a difference)

PAYMENT INFORMATION
  Payment Method: Card Number:
  Exp. Date CVV Code:
  Optional Comments:   I wish to pay the full annual donation
I wish to pay 12 Month Installments
You will be charged at the beginning of each month.
Begin payments on:
Other:
   

TOTALS:

 
    Partnership Total Amount:

    Total Amount to be charged today: