Printed from ChabadPR.com

Partnership Form

Partnership Form

SECTION I Your Information
Last Name
First Name
Hebrew Name
Father's Hebrew Name
Mother's Hebrew Name
Occupation
Birth Date [DD / MM / YYYY]
Day
Night
Jewish by
Birth Converted
I am a
Cohen Levi Israel
Cell Phone
Work Phone
Email
SECTION II Spouse's Information
Last Name
First Name
Hebrew Name
Father's Hebrew Name
Mother's Hebrew Name
Occupation
Birth Date [DD / MM / YYYY]
Day
Night
Jewish by
Birth Converted
I am a
Cohen Levi Israel
Cell Phone
Work Phone
Email
SECTION III Personal Information
Address
City/State/Zip
Home Phone
Marital Status: Single Never been Married Married Divorced Widowed
Anniversary Date [DD / MM / YYYY]
Divorce Date
(if applicable) [DD / MM / YYYY]

If divorced, do you have a Jewish Get?
Yes No
Who was Get administered by?
Widowed Date (if applicable) [DD / MM / YYYY]
SECTION IV Children
Child 1 Male Female Name
Hebrew Name
Birth Date [DD / MM / YYYY]
/ /
Day Night School
Child 2 Male Female Name
Hebrew Name
Birth Date [DD / MM / YYYY]
/ /
Day Night School
Child 3 Male Female Name
Hebrew Name
Birth Date [DD / MM / YYYY]
/ /
Day Night School
Child 4 Male Female Name
Hebrew Name
Birth Date [DD / MM / YYYY]
/ /
Day Night School
Child 5 Male Female Name
Hebrew Name
Birth Date [DD / MM / YYYY]
/ /
Day Night School
Child 6 Male Female Name
Hebrew Name
Birth Date [DD / MM / YYYY]
/ /
Day Night School
Child 7 Male Female Name
Hebrew Name
Birth Date [DD / MM / YYYY]
/ /
Day Night School
Child 8 Male Female Name
Hebrew Name
Birth Date [DD / MM / YYYY]
/ /
Day Night School
  Are any children adopted?
Yes No
If yes, give details, including any conversion info:
SECTION V Yahrtzeits
Name

[English / Hebrew / Father's Hebrew / Last]
Date of Passing [DD / MM / YYYY]

Day
Night
Relationship
Name

[English / Hebrew / Father's Hebrew / Last]
Date of Passing [DD / MM / YYYY]
Day
Night
Relationship
Name

[English / Hebrew / Father's Hebrew / Last]
Date of Passing [DD / MM / YYYY]
Day
Night
Relationship
Name

[English / Hebrew / Father's Hebrew / Last]
Date of Passing [DD / MM / YYYY]
Day
Night
Relationship
Name

[English / Hebrew / Father's Hebrew / Last]
Date of Passing [DD / MM / YYYY]
Day
Night
Relationship
Name

[English / Hebrew / Father's Hebrew / Last]
Date of Passing [DD / MM / YYYY]
Day
Night
Relationship
Section VI Partnership 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. Nobody will be turned away due to lack of funds.

Please select the option of your choice:
Partnership Annual Monthly
Family Partnership $990 $90
Seniors/Single Parent $600 $50
Section VII Chai Club Opportunities
Be a partner in our valuable work and community! Give Chai! Get Chai!

The Chai Club is comprised of individuals committed to the financial support of Chabad of Puerto Rico.

We rely on the commitment of the people of our community to ensure the financial stability of our organization. A crucial element of support for our work comes from hard-working individuals who commit to a monthly contribution. These monthly donations add up and make a great difference in covering our operational budget.

It's a great opportunity to give charity and to give back to Chabad for all we do. Any amount is really significant. As the Talmud says, “each and every penny adds up to a large amount”.

Please select the option of your choice:
Chai Club Partnership Level Annual Monthly
Chai Parternship $1,800 $180
Silver Partnership $2,500 $250
Gold Partnership $3,600 $360
Diamond Partnership $5,000 $500
Platinum Partnership $18,000 $1,800
Section IX Payment Details

I would like to make a High Holiday Seat donation: $100 per adult, please include seats $25 per child, please include seats (not including today’s payment). Please charge my card below on the first day of every month.

Total Amount
$
Card Type
Card Number
Expiration Date
Card Security Code
Comments/Special Requests

~ NOBODY WILL BE TURNED AWAY DUE TO LACK OF FUNDS ~

* All contributions are tax deductible and can be paid throughout the year. No one is turned away for lack of funds. If you cannot afford the full amount requested, contact the Rabbi @ rabbi@ChabadPR.com for a confidential arrangement.

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