Congregation Or Ami Partnership Form 2019-2020 - Form

ACCOUNT INFORMATION

Welcome to Congregation Or Ami! We are thrilled you are joining the partnership that is our congregational community.

Please fill in your contact information below.

Adult 1

* First Name:

* Last Name:

* Email:

* Cell Phone:

Birthdate

Anniversary

Occupation:

Company Name:

My company matches donations

Adult 2

First Name:

Last Name:

Email:

Cell Phone:

Birthdate

Anniversary

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 cell phone (if applicable), so our rabbis can be in touch with them, when necessary.

Child 1 Full Name:

School Attending in 2019-20:

Cell Phone:

Birthdate

Child 2 Full Name:

School Attending in 2019-20:

Cell Phone:

Birthdate

Child 3 Full Name:

School Attending in 2019-20:

Cell Phone:

Birthdate

Child 4 Full Name:

School Attending in 2019-20:

Cell Phone:

Birthdate

Young Adult Outreach Program

Even when your children graduate from high school, Or Ami remains their home. In an effort to stay in touch with the 18-25 year-olds in our congregation, we send birthday cards and holiday care packages to them throughout the year.

Would you like your 18-25 year-old child(ren) to be a part of this program?

We will contact you in the late summer via email to collect the mailing address(es) of your child(ren).

All young adult participants will receive a New Year's care package (delivered in October) and a birthday card with personal note from the clergy.

We would love to send two additional packages with your kind financial support. If you would like to opt in at $50 per child, we will send additional packages for Chanukah and Passover (each will include a yummy holiday treat, something fun, and warm note from the clergy). There is no pressure to opt in, all young adults will receive a birthday card and New Year's care package!

Opt in for additional care packages?

Cost will be added to your partnership fees.

Sponsor another young adult?

Donation will be added to your partnership fees.

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:

PARTNERSHIP

We invite you to be part of this vibrant Jewish community. Our partnership (membership) levels provide you with a personalized vibrant Jewish experience within a community committed to social action, Torah learning, and meaningful relationships. Your commitment opens doors for your family to enjoy exciting events as a part of a warm, inspiring, and musical community.

The actual cost of maintaining Or Ami's operations is approximately $5,000 per household. Committing at the Sustainer level enables us to completely cover our cost, and ensures Or Ami's vibrant future.

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

BUILDER

Help build Or Ami's future by committing to a generous contribution.

Household: $10,000

BUILDER LEVEL includes all of the SUSTAINER offerings, plus 4 additional High Holiday tickets ($1,200 value), 2 additional Or Ami One (Gala) tickets ($300 value), 2 retreat tuitions ($600 value - for Triple T or 4th-6th grades), inclusion in Or Ami One (Gala) Tribute Book ($500 value), and 1 FREE PARTNERSHIP for 1 year to gift to a new family ($3,500 value - this gift does not include Religious School or B'nai Mitzvah tutoring tuition).

Join at Builder Level

SUSTAINER

Joining at the level covers the actual cost of your household's involvement.

Household: $5,000

SUSTAINER LEVEL includes all of the PARTNER offerings, plus an invitation to a special donor recognition celebration, participation in congregational Shabbat Dinners ($240 value), Tashlich at the Beach parking ($25 value), local LoMPTY events ($190 value - not including NFTY SoCal or Or Ami retreats), 2019-2020 B'nai Mitzvah fees ($950 value - does not include tutoring fees), and two additional High Holiday Tickets ($700 value).

Join at Sustainer Level

PARTNER

This is the minimum level of commitment required if you have any children in Religious School, from Kindergarten through 12th Grade.

Two Adult Household: $3,100
One Adult Household: $2,050

PARTNER LEVEL includes all of the CONGREGANT offerings, plus Or Ami One (Gala) tickets for adults in household (up to $300 value), Women's/Men's Night Out ($120 value), Speaker Series ($180 value), as well as access to Religious School (Kesher 3.0, Mensch-ify, and/or Triple T) and Bar/Bat Mitzvah programs, both of which require separate tuition.

Join at Partner Level

Two Adult HouseholdOne Adult Household

CONGREGANT

Two Adult Household: $1,600
One Adult Household: $1,050
Two Young Adult Couple or Family (under age 36): $500
All children must be under Kindergarten age. Includes access to enrollment in Mensch-ify Tots. Community Service Assessment and Security & Safety Fees are waived.
One Young Adult Individual or Family (under age 36): $250
All children must be under Kindergarten age. Includes access to enrollment in Mensch-ify Tots. Community Service Assessment and Security & Safety Fees are waived.

CONGREGANT LEVEL includes High Holiday Tickets for adults and children under age 26, weekly Shabbat services, Empty Nester gatherings, Business Roundtable, LoMPTY teen membership, and access to clergy (spiritual counseling, lifecycle events, etc.). Or Ami One (Gala) requires purchase of tickets ($150/person).

Join at Congregant Level

Two Adult HouseholdOne Adult HouseholdTwo Young Adult Couple or Family (under age 36)One Young Adult Individual or Family (under age 36)

ASSOCIATE

For full dues-paying members of another synagogue.

Household: $1,300

ASSOCIATE LEVEL includes 2 adult High Holiday tickets, monthly mailings, and bulletin. Some restrictions apply on voting privileges and life cycle officiation by clergy. Or Ami One (Gala) requires purchase of tickets ($150/person).

Join at Associate Level

All levels pay a $225 Community Service Assessment Fee.

Your Community Services Assessment allows Or Ami to directly support local, national, Israeli, and international Jewish projects beyond the Congregation walls.

All levels pay a $275 Security & Safety Fee.

Your Security & Safety Fee helps us address real-world security and safety concerns within the Congregation and during off-site programs.

PAYMENT

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

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

* Payment Plan:

Partnership fees must be paid in full by April 30, 2020.

Payment Method (if payment due):

Partnership fees paid by CHECK by June 30, 2019 will receive a discount of $50 for a One Adult Household and $100 for a Two Adult Household.

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 partnership fees. We will contact you to confirm your payment plan before charging your card.

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 Partnership Commitment and other fees and fees as and 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.

* Please tell us how you heard about Or Ami:

If Other, please specify: