Friends of CSS Member Form

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Home
Donate

* First Name

* Last Name

* Adult 1 Email

Adult 1 Cell

Birthdate

Adult 2 First Name

Adult 2 Last Name

Adult 2 Email

Adult 2 cell

Birthdate

* Home Address

* City

* State

* Zip code

Home Phone

Child 1

Birthdate

Grade

Child 2

Birthdate

Grade

Child 3

Birthdate

Grade

Child 4

Birthdate

Grade

I would like to observe the following yarhzeits:

Provide name of deceased, relationship to you, date of death (mm/dd/yyyy) and if you want to observe the Hebrew or English date.

How would you like to connect with us? Check all that apply.

Weekly emails (includes calendar of events and birth/death notices)Monthly newsletter (paper)Monthly newsletter (electronic)Include in Friends Category in printed member directory

We ask for a flat annual donation of $180 for this category of membership.

* Pledge

Sat, July 27 2024 21 Tammuz 5784