B'nai Tzedek Sign-Up Form

B'nai Tzedek Sign-Up Form

Take your first step into youth philanthropy and begin a lifelong journey of giving, inspired by tzedakah, the value of justice, and tikkun olam.
Please fill out the appropriate information below.
B'nai Tzedek Fund Holder Information
Teen Name*

First NameLast Name
Teen Birth Date*

MonthDayYear
Date
Teen Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Teen Phone Number*
Please enter a valid phone number.
Teen Email*
example@example.com
School Name*
Graduation Date*
Name of Synagogue *
Date of Bar/Bat Mitzvah*

MonthDayYear
Date
Parent/Guardian Information
Parent/Guardian #1*

First NameLast Name
Parent/Guardian #2

First NameLast Name
Parent/Guardian #1 Phone Number*
Please enter a valid phone number.
Parent/Guardian #2 Phone Number
Please enter a valid phone number.
Parent/Guardian #1 Email*
example@example.com
Parent/Guardian #2 Email
example@example.com
Preferred Method of Contact (Parent/Guardian #1)*

PhoneEmail
Preferred Method of Contact (Parent/Guardian #2)

PhoneEmail
Parent/Guardian #1 Address*

Same as ChildNew Address
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian #2 Address

Same as ChildNew Address
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Sign up is not complete without a JewishColumbus receipt of $125.

On September 30 following the fundholder’s 19th birthday the fund must be closed out in one of the following ways:
- Designate the remaining funds to support a community program or organization of your choice.
- Allow JewishColumbus to make the designation on your behalf.
- Convert your fund into a Young Adult Donor Advised Fund.
JewishColumbus will contact you at the appropriate time to fulfill this step.
Should be Empty:

B'nai Tzedek Sign-Up Form

B'nai Tzedek Fund Holder Information

Parent/Guardian Information