Donation Form Thank you for making this contribution to Congregation Kol Ami online. An acknowledgment will be emailed to you. If you do not see an acknowledgement email, there is a chance your donation did not successfully submit. If so, please contact us at 323-606-0996 or email us at staff@kol-ami.org and we will immediately correct the situation. Designation: You may choose an suggested donation amount from the drop down menu or choose "Other" and write in the donation amount of your choice in the text box below. Then choose the fund your donation is meant for. You must choose one and only one fund. If you would like to make donations to more than one fund, please make two separate submissions. If you would like to make a donation to a Hannukah Candle, please write in which candle in the "Honoree or Tributee Name" text box. If you have any questions please contact the Temple office at (323) 606-0996 or staff@kol-ami.org. Thank you! Please select the fund you would like this donation to be designated for:*General FundHigh Holiday DonationIndividual Membership Dues $1750 ($1600 + mandatory $150 Building Maintenance Fee)Family Membership Dues $2525 ($2375 + mandatory $150 Building Maintenance Fee)Arza ($50 per household)MOKA/WOKA Individual Membership ($35)MOKA/WOKA Dual Membership ($70)Giborim: Chesed (Kindness and Goodness)$500 - $1799Giborim: Chai (Life) $1800 - $3599Giborim: Double Chai $3600 - $5399Giborim: Triple Chai $5400 - $9.999Rabbi's Silver Circle $7,500 - $15,000Rabbi's Gold Circle $15,000+Yarzeit Donation (in loving memory)Annual Oneg Sponsor ($520)Oneg Shabbat Sponsor ($150)Bima Flowers Sponsors ($300)Building FundEndowment FundRabbi's Discretionary FundHarvey Weiner Memorial 12-Step FundHoward Jacobs Memorial HIV Lunch FundJulia Graves-Broidy Education FundEdythe Siteman Music FundElaine A. Newman ScholarshipWendy Sukman Women's Health FundMembers Yarzeit Plaque Dedication ($650)Non-Members Yarzeit Plaque Dedication ($1200)Sanctuary Chair Dedication ($1000)Library Shelf Plaque ($250)Shabbat Prayer Book Dedication ($100)Shabbat Song Book Dedication ($30)Chumash (Torah Commentary) Dedication ($100)Hannukah Candle ($100)Please choose a donation amount:*$36$50$75$150$250$360$450$500$1000$1800$2500$3600$5000OtherIf you chose "other", please enter the donation amount you'd like to give at this time. Please enter a numerical amount. Please only enter the number with no dollar sign i.e. "18".*Is this donation made in honor of someone? Is there an special occasion? Please let us know how you would like this donation to be listed.Example: "In honor of my sister, Jane" or "In memory of my mother, June." Or "In honor of Jane Smith's Bat Mitzvah."Please list how you would like your name listed as the donor.Jack Smith or Jack and Elaine Smith or The HBC Commission.If you would like your Honoree or Tributee to be emailed a notification of your donation (with no discussion of the amount) please enter their email here: Total Donation Amount: Payment InformationCredit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Expiration Date Security Code Cardholder Name Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country This iframe contains the logic required to handle Ajax powered Gravity Forms.
