B NAI TORAH CONGREGATION
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1 2 Membership Options Please consider going CHAI-er B NAI TORAH CONGREGATION Family Single Platinum Chai $11,000 $5,500 Golden Chai $ 4,700 $2,400 Silver Chai $ 2,750 $1,400 Standard $ 1,900 $ 875 Young (36-40) $ 1,100 $ & Under $ 400 $ 200 ECC Family $ 518 (includes security fee) N/A Israel Bonds $ 36 (optional) $ 36 (optional) Security Fee* $ 218 $ 118 Capital Fund ++ $ 600 (per year for 6 years) $ 300 (per year for 6 years) *Required for all membership levels except for ECC Family membership ++ If applicable sub-total Line 1 OPTIONAL DONATIONS* - Many wonderful things are possible with your support. Thank you! Women s League Dues (See enclosed form) $36 Men s Club Dues (See enclosed form) $36 Jacobson Family Food Pantry (Operated through Jewish Family Services) $18 Masorti (Umbrella Organization of Conservative Movement) $18 Kiddush Fund (Helps defray costs of weekly Oneg) $36 Hazak (USCJ Organization for Mature Jews 55+) $12 Daily Minyan (Helps defray costs of daily breakfast) $20 Finkelstein Youth Group Fund (Provides scholarships & sponsors Yad Program) $18 Friends of JTS (Supports Jewish Theological Seminary) $36 Sam Mandelker z l College Connection Fund (Helps defray costs of care $36 packages for our College Students) High Holy Day Flower Fund $180 Lulav & Etrog Set (Purchase a set for your home) $47 Meryl & Ron Gallatin TLC Program (Tzedakah, Learning & Chessed) $18 sub-total Line 2 *(Optional Donations must be paid in full at time of application)
2 3 B NAI TORAH CONGREGATION HIGH HOLY DAY 5777 TICKET REQUEST This form must be submitted by July 31, 2016 to receive High Holy Days tickets. NAME All members: Please indicate which service you wish to attend. I would like to be an usher I would like to blow shofar I will not be attending High Holy Days Services (Family = 2, Single = = 1) 1) Platinum/Gold Chai Sanctuary Cost) Silver Chai Sanctuary Cost) Sanctuary Service Cost) Weiner CC Service Cost) Total $ Adult Tickets Included with Membership $0 $0 $0 $0 $0.00 # of Membership Children Tickets (ages 6-26 as as of of 9/1/16) $200 $150 $150 $36 _ # of of Guest Guest Adult Adult Tickets Tickets (out-of-town (out-of-town relatives/member relatives/member adult $425 $375 $375 $225 _ adult children, children, age 27 age and 27 older) and older) # of Guest Children s Tickets (out-of-town relatives, relatives, ages ages 6- $225 $200 $200 $150 _ 6-26 as of 9/1/16) 26 as of 9/1/16) Platinum Chai & Golden Chai Chai upgrades, for for immediate family $100 _ family who are members. Please list names below. who are members. Sub-TOTAL $ Line 3 List names: SPECIAL NEEDS REQUESTS: Aide/Caretaker ticket needed Wheelchair seating requested Other KOL NIDRE 5777 My/our Kol Nidre gift is enclosed. I/We are pledging to the Kol Nidre Campaign. $ $ Please contact me to discuss my/our gift. Sub-TOTAL $ Line 4 IMPORTANT!! I understand that by requesting High Holy Days tickets I am obligated to pay the full amount of my Annual Dues, Capital Fund and Security Fees to B nai Torah Congregation. (Please Initial) Tickets are non-transferable and non-refundable (Please Initial)
3 B nai Torah Congregation Bond of Life A Book of Remembrance & Celebration 4 Please complete and return this form with your payment to the Synagogue by July 31, The Bond of Life book allows us to remember all of our life cycle events, such as deaths, births, B nai Mitzvot, anniversaries, etc. Consider becoming a Patron of the Bond of Life book for $360. Patrons are entitled to a total of 18 listings for a Remembrance and/or a special simcha, and are honored in a special Patron section of the book. You may choose to list your loved ones individually in the Remembrance or simcha section for $18 per listing. (*One person or couple per listing) q Please include my listings as a Patron in the Bond of Life $360 q I would like listings at $18 each in the Bond of Life Book ** $ PLEASE PRINT LEGIBLY! Contributor name(s) exactly as you would like it to appear in the book: City State Zip Phone: address: REMEMBRANCE SECTION - to remember departed loved ones (*One person or couple per listing) In Memory of: Listing 1 Listing 2 Listing 3 Listing 4 Listing 5 Listing 6 Listing 1 Listing 2 Listing 3 Listing 4 Listing 5 Listing 6 SIMCHA SECTION - to celebrate other life cycle events (*One person or couple per listing) SPECIAL MEMORIAL SECTION - You may add your name to special memorial pages for Holocaust Remembrance, Yitzhak Rabin z l and the late Gabbai Emeritus George Goldstein z l at a cost of $36 per listing. In order to be included in the special memorial page(s) place an X below and enclose the appropriate payment: holocaust Remembrance Page $36 Yitzhak Rabin z l Memorial Page $36 George Goldstein z l Memorial Page $36 ** 18 listings maximum PAGE TOTAL $ Line 5
4 5 Women s League of BTC Where every woman s voice is heard! WLBTC Women s League Membership Join now or Renew! $36 BTC members, $45 Non-members Please make checks payable to WLBTC or go to to pay for your membership online. Name: New Member Current Member Section I - Contact Information (* If you are a current member and your information hasn t changed, proceed to Section II) Home Phone: Cell Phone: Address: City: State: Zip: Name of Community: Is it gated? Yes No Birthday: Anniversary: Section II - Interest I am interested in: Book Club: Rosh Chodesh: Games: Arts & Crafts: Other: I would like to help with: Judaica Shop: Greeting/Calling Members: Mailings: Cooking: Baking: Social Action: Event Planning: Special skills I can volunteer (ie. data processing, sales, arts & crafts, etc): For more information, contact WLBTC Membership VP, Barbara Weiss at barbweiss48@gmail.com or (954) B nai Torah Men s Club involving jewish men in jewish life! BT Men s Club Membership Join now or Renew! $36 BTC members and non-members Please make checks payable to B nai Torah Men s Club. Name: New Member Current Member Section I - Contact Information (* If you are a current member and your information hasn t changed, proceed to Section II) Home Phone: Cell Phone: Address: City: State: Zip: Name of Community: Is it gated? Yes No Birthday: Anniversary: Section II - Interest I am interested in: Community: Spirituality: Social Action: Synagogue/Ritual: Sports League: Father & Son/Daughter Activities: Other: I would like to help with: World Wide Wrap: Super Bowl Party: Community Activities: Publicity/Communications: Men s Club Shabbat: Yellow Candle: Social Action: Membership: For more information, please contact Larry Faerman, Men s Club President, at larryfaerman@gmail.com.
5 B NAI TORAH CONGREGATION 6 CHILDREN & TEENS HHD PROGRAMMING REGISTRATION FORM This form must be submitted by July 31, Babysitting (age 1 through pre-k): *No charge. Babysitting is generously underwritten by Gabriela Weiss. Kindergarten through 5th grade: Your child will be assigned to a classroom according to his/her grade in school. The Children s program will be for 1st and 2nd day of Rosh Hashanah and for Yom Kippur from 9:00 a.m. - 1:00 p.m. The program is free for your child(ren). When you arrive, please go to the room to which your child was assigned. You will be greeted by a room supervisor who will hand you an index card with your child s name on it. It is important for you to keep this card since you will need it to pick up your child. Our room supervisors will not release your child if you do not have the card, and they will only release your child to an adult so please do not send siblings. As you enter the classroom, the room supervisor will place a sticker next to your child s name to mark that the child is checked in. The room supervisor will ask if you child has any food allergies. We will have another sticker to note that there is a food allergy. While your child is in our program they will have the opportunity to play with friends, participate in High Holy Days activities and age-appropriate services. We will also have Shofar blowers rotating through the classrooms so your child will have the opportunity to fulfill the mitzvah of hearing the Shofar. Grades 6th through 12th: The 6th through 12th graders will have a High Holy Days service at 10:30 a.m. conducted by Cathy Berkowitz, Mirochnick Religious School Education Director. The service will run for approximately 1 ½ hour. The program is free for your child(ren). Before and after the service, our students will have the opportunity to spend time with their friends. We expect our youth to behave and dress properly. If your child is not displaying proper conduct, we will bring your child to the service and they will need to stay with you. Please feel free to have your child bring in board games, cards, etc. that are appropriate to be used on Yom Tov. They will not be allowed to use electronic games, cell phones and ipods. If you have any questions please contact Cathy Berkowitz at (561) ext. 329 or cathy.berkowitz@bnai-torah.org Member s Phone #: please Check the program your child will attend (Grade as of 9/1/16) Date of Birth GRADES K-5 (No charge) GRADES 6-8 (No charge) GRADES 9-12 (No charge) BABY- SITTING Age 1 to Pre-K *(No charge) BABY- SITTING Age 1 to Pre-K *(No charge)
6 B nai Torah Congregation and the Ruth & Edward z l Taubman Early Childhood Center invite you to 7 A Rosh Hashanah & Yom Kippur early childhood Service Rosh Hashanah: monday, october 3, 2016 at 9:00 a.m. Yom Kippur: wednesday, october 12, 2016 at 9:00 a.m. Celebrate the High Holy Days with your child and fellow Early Childhood Families (ages 2-6) Strollers welcome! Introduce your children to the importance of these special days at B nai Torah Congregation Location: Education Social Center ALL ARE INVITED TO JOIN US AT NO CHARGE! RSVPs ARE REQUIRED BY august 31st Name (Adults) Phone Child Age School Child Age School Child Age School Address City Zip Code Rosh Hashanah SERVICE ON OCTOBER 3rd Total number of people attending YOM KIPPUR SERVICE ON OCTOBER 12th Total number of people attending For security purposes, please list any other members of your party (first and last name): AlL tickets will be issued in advance. Tickets will not be available at the door. for more information contact Erica Gordon AT (561) ext.348 or erica.gordon@bnai-torah.org. B nai Torah Congregation 6261 S.W. 18th Street, Boca Raton, FL (561)
7 The Sam Mandelker z l College Connection at B nai Torah Congregation will send Yom Tov Packages to your College or Graduate Students 2016/ Rosh Hashanah Chanukah PuriM Passover For details, call AviGail Whiting at (561) ext. 308 Please fill out the form and mail or fax it to the Synagogue Office: 6261 SW 18th Street, Boca Raton, Florida Phone: (561) Fax: (561) Student Name: Birthdate: Student Student Cell: Student Address: City: State: Zip: College Name: Parent Name: Parent Cell: Year of Graduation: Parent Address: City: State: Zip: Parent I would love to volunteer to put together these wonderful packages The complimentary care packages are great! To show my appreciation, I would like to support the Sam Mandelker z l College Connection by making a donation (see Accounting Form) * You can keep your young adult connected after their college graduation for the minimal cost of $50. This will cover our expenses to keep your child on our list for the full holiday season from Rosh Hashanah to Passover. Please check payment method: Visa MasterCard American Express Check # Credit Card #: Exp. Date: Name as it appears on card: TOTAL $: Billing Address: CVV: Signature:
8 9 Youth Department Come join in on the fun! USY - Grades 9-12 Kadima - Grades 6-8 Bonim - Grades 2-5 Chalutzim - Grades K-1 I m interested in learning more! Please contact me. Name: Address: Phone #: Grade: Parent Name(s): Parent Contact Information: Phone #: Address: Find us on: For more information, please contact our Youth Advisors Stephanie Goldstein, Zach Smith or Andrei Sujka at brusy@bnai-torah.org
9 10 B NAI TORAH CONGREGATION ACCOUNTING SHEET Membership Dues, Capital Fund & Security Fee - Line 1 (from pg. 2) Optional Donations - Line 2 (from pg. 2) Extra High Holiday Seats - Line 3 (from pg. 3) Kol Nidre - Line 4 (from pg. 3) Bond of Life - Line 5 (form required, pg. 4) If applicable: Mirochnick Religious School, including Youth Group (form required) B nai Mitzvah Program (Annual Fees) OTHER *$72 annual credit card one-time processing fee if paying by credit card PAGE TOTAL $ REQUEST for payment plan of Synagogue Financial Obligations (Optional) NOTE: July, August & September MUST be paid in full in order to receive HHD tickets Please read carefully! This request for payment plan must include your authorization to charge your credit card according to the schedule you have chosen with payments starting July 10, Monthly (Ten equal payments on the 10th of the month, July through April) Quarterly (Four equal payments on the 10th of July, October, January and April) Semi-Annually (Two equal payments on the 10th of July and January) I acknowledge that this payment plan is offered as a convenience to me, and that my payments will be credited to my financial obligations at the discretion of B nai Torah Congregation. I hereby authorize B nai Torah Congregation to charge my credit card in order to pay my financial obligations to the Congregation for the fiscal year according to the schedule I have specified as follows: Dues, Capital Fund, Security, Mirochnick Religious School tuition and Bar/Bat Mitzvah fees, Kol Nidre as applicable. If my request for the payment plan is received after July 1st, I authorize my first payment in the amount that will satisfy all payments due at that time according the schedule I have chosen. This authorization to charge my credit card will remain enforced until all the aforementioned obligations have been paid in full. Should I resign my membership after submitting this form, or registering my child(ren) in Mirochnick Religious School, I understand that I am not entitled to any refund, rebate or discount. I agree that in the event that my credit card carrier or bank will not process the charges authorized above according to the schedule indicated, B nai Torah Congregation may take the following actions: 1. Require me to submit my payment by personal or cashier s check within five (5) business days or 2. Charge my credit card for the full payment due on my account, including arrears caused by missed payments, as soon as the charge can be processed. I further agree that if my credit card cannot be charged for three (3) successive billing periods, B nai Torah Congregation may require me to pay my account in full immediately by bank check or money order. A returned check penalty fee of $25 will be charged to your account for any check(s) returned by your bank. Signature Printed Name CC# Exp. Date CVV Name on Credit Card
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