Annual Banquet - Form - Congregation KINS of West Rogers Park

Join us at this year's KINS Annual Ad Banquet honoring Jenny & Kenny Landsman (Ahavat Chesed Award) and Alan & Devora Sorscher (Avodat Kodesh Award) on June 8, 2017! There will also be a special memorial tribute to Mrs. Rachel Neikrug, z"l.

Please fill out the form below to place an ad or make a reservation for the dinner.

THE AD DEADLINE IS SUNDAY, MAY 28th.

* First Name

* Last Name

* Address

* City, State, Zipcode

* Country

* Phone number

* Email

sponsorship

Leader's Page..........$10,000 (call for details)

Benefactor's Page..........$7,500 (call for details)

Special Page..........$5,000 (call for details)

Parchment Page..........$3,600 (includes table of 10)

Diamond Page..........$2,500 (includes table of 8)

Platinum Page..........$1,800 (includes 6 dinners)

Gold Page..........$1,000 (includes 4 dinners)

Silver Page..........$750 (includes 4 dinners)

Bronze Page..........$540 (includes 2 dinners)

Full Page..........$375 (includes 2 dinners)

Half Page..........$250 (includes 1 dinner)

Quarter Page..........$125

Dinner Only..........$125/person

Dinner Only(under age 30)..........$90/person

Other donation amount

Number of ads placed above

Total number of dinner reservations requested

Please list the names of the people for whom you are requesting dinner reservations

Please write in the text of your ad(s) below:

Jewels ($5.00 each): Please select how many children and grandchildren you would like to honor.

Please list the names of the children and grandchildren that you would like to honor below:

Greetings ($5.00 each) for each of the following will be listed on separate pages; please select as many as you wish:

Memorials ($5.00 each) for the following K.I.N.S. members, z"l, who have passed away since the last ad book was printed in June 2016. Please select as many as you wish; if we have omitted a name, please use the area below to add them.

Additional Names

Please fill in any additional names below

Your total gift is:

Thank you for your generous support.