Kol Ami, The Northern Virginia Reconstructionist Community
Rosh Hashanah and Yom Kippur worship will be at the UUCA. Click here for directions.
Please check one: _____ I am a member. _____ I am a visitor.
There is no additional charge for members to attend High Holiday services. The requested contribution for visitors is based upon individual services attended; however, if you are attending all High Holiday services the suggested contribution is $162.00 (please see below). You will not be turned away for financial reasons - if you are unable to give the full amount, indicate how much you can contribute.
Contributions are not required (but are always appreciated) for children
under 18 years of age attending either the main service or a children's service;
however, please include names below.
| Name: | ___________________________________________________________ |
| Second Adult: | ___________________________________________________________ |
| Address: | ___________________________________________________________ |
| City/State/Zip: | ___________________________________________________________ |
| Phone: | _____________________ | Email: | _____________________ |
| Names of Additional Adults: | _________________________________________________ |
| _________________________________________________ | |
| _________________________________________________ | |
| _________________________________________________ |
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Children's Information |
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| Name |
Attending Tot or Children's Service for |
Age | Grade/Secular School |
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Contribution:
| # | Category | Amount |
| __ | Adult Kol Ami Members for ___ both holidays ___ Rosh Hashanah ___ Yom Kippur | |
| __ | Nonmember Adults for both holidays - $162.00 | |
__ __ __ __ __ |
Nonmember adults use this table if not attending all High Holiday
services: Erev Rosh Hashanah - $36.00 Rosh Hashanah Day - $36.00 Kol Nidre - $36.00 Yom Kippur Day - $36.00 Ne'ila - $18.00 |
$______ $______ $______ $______ $______ |
| __ | Adults accompanying children to services Rosh Hashanah _____ Yom Kippur _____ At least one parent is required to attend. | $______ |
| __ | Adults for Rosh Hashanah Day Luncheon - $10.00 | |
| __ | Adults for Break Fast - $10.00 | |
| __ | Additional contribution to support Kol Ami | $______ |
| Total Contribution | $______ |
Please send your check, payable to Kol Ami, with this form to the address above.
Contributions are tax
deductible.
If you join Kol Ami when you make your reservations, please also complete a
Membership Form and mail both forms, along with
applicable dues (High Holiday contribution not required), to the address above.
If you join Kol Ami within 90 days of the High Holy Days you may apply your
High Holiday contribution to membership.
If you are a visitor, please tell us how you heard about Kol Ami: ___________________________________________________