Join Or Ami's Neighborhood Form 2022-2023 - Form

Welcome to Or Ami’s Neighborhood,
a way to deepen your relationship with Congregation Or Ami
even when you don’t live close by.
By joining Or Ami’s Neighborhood, you strengthen your connection
with our spiritual community, with Jewish life, with our clergy, and with each other.

The Neighborhood is open to anyone who lives 60 miles or more
from Congregation Or Ami’s Calabasas sanctuary.
We do ask that either you or a member of your immediate household is Jewish.

ACCOUNT INFORMATION

Please fill in your contact information below.

Adult 1

* First Name:

* Last Name:

* Email:

* Cell Phone:

Birthdate

Anniversary

Faith of Adult 1

JewishOther

If "Other" Faith, Please Explain (so that we can be especially welcoming)

Occupation:

Company Name:

My company matches donations

Adult 2
(if applicable)

First Name:

Last Name:

Email:

Cell Phone:

Birthdate

Anniversary

Faith of Adult 2

JewishOther

If "Other" Faith, Please Explain (so that we can be especially welcoming)

Occupation:

Company Name:

My company matches donations

Household

* Home Mailing Address:

* City:

* State:

* Zip Code:

Home Phone:

Children

*Please provide us with your child(ren)'s name(s) and cell phone (if applicable), so our rabbis can be in touch with them, when necessary.

Child 1 Full Name:

School Attending in 2022-23:

Cell Phone:

Birthdate

Child 2 Full Name:

School Attending in 2022-23:

Cell Phone:

Birthdate

Child 3 Full Name:

School Attending in 2022-23:

Cell Phone:

Birthdate

Child 4 Full Name:

School Attending in 2022-23:

Cell Phone:

Birthdate

Yahrzeit

We want to make sure that we have a complete list of Yahrzeit dates (anniversary of death) so we can send you a reminder of when to say Kaddish (memorial prayer). Please enter your Yahrzeit information below.

First Name:

Last Name:

Related to:

Adult 1Adult 2

Relationship:

Date of death:

First Name:

Last Name:

Related to:

Adult 1Adult 2

Relationship:

Date of death:

First Name:

Last Name:

Related to:

Adult 1Adult 2

Relationship:

Date of death:

BECOME A NEIGHBOR

We invite you to be part of this vibrant Jewish Neighborhood. Our neighborhood provides you with an engaging experience within a community committed to deep spirituality, social action, Torah learning, and meaningful relationships. Your commitment opens doors for you to enjoy exciting events as a part of a warm, inspiring, and musical community.

Please check the box on the right to select your Neighbor commitment level.

SUSTAINING NEIGHBOR LEVEL

Household: $1,000

Join at Sustaining Neighbor Level

Sustaining Neighbors, in addition to all the benefits of being a Neighbor, enjoy two individual online sessions with one of our rabbis. Sustainers' additional gifts support our Neighborhood and help ensure others can become Neighbors.

NEIGHBOR LEVEL

Single Adult Household: $250
Two Adult Household: $500

Join at Neighbor Level

One-Adult-HouseholdTwo-Adult-Household

Neighbors enjoy all the benefits described on Or Ami's Neighborhood homepage

PAYMENT

Please tell us how you would like to pay your neighborhood commitment fees.

All neighborhood commitment fees are 100% tax deductible to the fullest extent of the law.

* Payment Plan:

Neighborhood commitment fees must be paid in full by April 30, 2022.

Payment Method (if payment due):

Paying by Credit Card: After submitting this form, you will be taken into your secure account where you will be able to add a preferred card for paying your neighborhood commitment fees. We will contact you to confirm your payment plan before charging your card. You may also call the temple office at 818-880-4880 to give your credit card number.

TERMS

* I have read and fully agree to the terms below (please write full name):

The undersigned hereby represents, warrants and agrees that (i) he/she has read and understood the content of this Application, (ii) all the information provided to COA herein is true and correct as of the date hereof, (iii) he/she agrees to be bound by the terms hereof including the payment of the Neighborhood Commitment Fees and other fees when due and payable hereunder, (iv) he/she agrees to pay a late fee of two percent (2%) per month on the unpaid balance of dues and fees not paid as and when due hereunder, (v) he/she shall abide by the bylaws, rules and regulations of COA as they currently exist and/or as they shall be amended or adopted during the term of this membership, (vi) that COA may publish and republish photographs and videos taken of me and my family at any and all COA events. Said publication may include COA’s newsletter, website, Facebook, Twitter, Instagram, social media, e-newsletters and other publications, and local and national media as it shall determine, and (vii) COA may include the information on this form in a roster that is distributed only to the COA community. Furthermore, I consent that such photographs and or videos shall be the property of COA, which has the right to duplicate, reproduce and make other uses as COA deems necessary. The undersigned authorize COA to publish photographs of me and my family for the express purposes consistent with the mission and operations of COA.

Tell Us More About You/Your Family

Is there anything specific that you can tell us about you/your family that will help us make your experience more meaningful?

Please let us know where you need support and/or have an interest. Check the box(es) below that fits for you/your family.

If there are other areas of support or interest for you/your family, please let us know:

* Please tell us how you heard about Or Ami:

If Other, please specify: