Online Membership Form -- Part II

Custom Membership Level

Please indicate the amount you intend to give for membership*: You will be asked to enter this amount again during checkout.

Referring to the list below, please put the number of each gift you wish to receive in the box according to the next lowest dollar amount level. (For example, if you give $136, you may choose two gifts, according to the Rebecca Level.) When you're done, click on the button marked "Proceed to Payment" to proceed to the payment page:
When you join our community at various levels, you will receive these gifts:

Miriam Level -- $36: Thanks for helping to sustain our monthly services
Rachel & Leah Level -- $72: Choose one gift from the below list
Rebecca Level -- $118: Choose two gifts, the same or different
Sarah Level -- $360: Take one of each, or any combination of three gifts

A custom Lev Eisha heart keychain
The Bridge to Forgiveness: Stories and Prayers for Finding God and Restoring Wholeness by Karyn D. Kedar
The Lev Eisha CD: Shabbat Songs from a Woman's Heart?

Name*:

Address*:

City*:      State*:    Zip*:

Phone (with area code)*:

E-mail (IMPORTANT)*:

(optional) This is a GIFT membership, donated by:

  * indicates a required field

If you have any questions, please e-mail the Membership Chair.

Lev Eisha--A joyous community of Jewish women engaged in prayer, study and spiritual growth

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