Personal Information Full Name* First Name Last Name E-mail* Phone Number Celebration Information Celebration Type* Baby NamingBar MitzvahBat MitzvahOther What's the celebration?* Baby's Hebrew Name Mom's Hebrew Name Please select all that apply: I would like to Celebrate with Sponsoring a Shabbat KiddushI would like to select the Honors for a Shabbat CelebrationI would like to select the Honors for a Monday/Thursday CelebrationI would like to add pictures for the Shul Screen Mother's Mom's Hebrew Name Celebration Kiddush Date* Month Day Year Kiddush Options $500 Co-Sponsor$1000 Sponsor Kiddush$1800 Deluxe Kiddush$2500 Premium Kiddush Honors List for Shabbat Celebration Opening the Ark Name Relationship to Celebrant Passing the Torah Name Relationship to Celebrant 1st Aliya - Kohen Hebrew Name and Father's Hebrew Name Relationship to Celebrant 2nd Aliya - Levi Hebrew Name and Father's Hebrew Name Relationship to Celebrant 3rd Aliya Hebrew Name and Father's Hebrew Name Relationship to Celebrant 4th Aliya Hebrew Name and Father's Hebrew Name Relationship to Celebrant 5th Aliya Hebrew Name and Father's Hebrew Name Relationship to Celebrant 6th Aliya Hebrew Name and Father's Hebrew Name Relationship to Celebrant 7th Aliya Hebrew Name and Father's Hebrew Name Relationship to Celebrant Maftir / Haftarah Hebrew Name and Father's Hebrew Name Relationship to Celebrant Lifting the Torah Name Relationship to Celebrant Dressing the Torah Name Relationship to Celebrant Returning the Torah Name Relationship to Celebrant Kiddush Name Relationship to Celebrant Hamotzei Name Relationship to Celebrant Honors List for Monday and Thursday Celebration Opening the Ark Name Relationship to Celebrant Passing the Torah Name Relationship to Celebrant 1st Aliya - Kohen Hebrew Name and Father's Hebrew Name Relationship to Celebrant 2nd Aliya - Levi Hebrew Name and Father's Hebrew Name Relationship to Celebrant 3rd Aliya Hebrew Name and Father's Hebrew Name Relationship to Celebrant Lifting the Torah Name Relationship to Celebrant Dressing the Torah Name Relationship to Celebrant Returning the Torah Name Relationship to Celebrant Family Pictures (For more then 6 pictrues please email the pictures to [email protected]) Picture 1 Picture 2 Picture 3 Picture 4 Picture 5 Picture 6 Comments: Total $0.00 Payment Credit Card Paypal Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration YearPaypal has been selected. Payment will take place on the next page.Billing Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Submit Should be Empty: This page uses TLS encryption to keep your data secure.