Young Israel of Skokie ד"סב

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Young Israel of Skokie

‫בס"ד‬

Payment Form 5777 / 2016-2017 Name: Please check all appropriate boxes Rate

‰ Life Member

Total

$36,000

‰ Pillar of Young Israel

$5,000

‰ Sustaining member

$3,000

‰ Family membership

$1,400

(50% off for First Year - $700)

‰ Single membership

$700

(50% off for First Year - $350)

‰ Associate membership

$300

(Does not include High Holiday seating or voting privileges)

‰ Guest seats for out-of-town family or friends Guests

‰ Babysitting

@ $150 each @ $10 per child per day @ $25 per child for all 3 days

‰ Building Fund ­ Obligation, Donations & Sponsorships ‰ Memorial Book (please attach form) Total Due

0.00

Method of Payment ‰ ‰

Payment in full or

 Checks Enclosed

3 Monthly Payments

 Credit Card Payments o Discover o Visa o MasterCard

or

‰

5 Monthly Payments

Card No. __________________________ Code _____ Exp. Date_____ /_____ Signature ___________________________________ Date __________________ For any other financial arrangement, please contact Steve Krinsky Phone 847-677-1291 (home) 847-677-8400 (work) or email [email protected]