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			<h1 class="article-header__title js-article-title js-page-title">RSVP & Dedications</h1>
		
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<div class="pagetitle">RSVP &amp; Dedication Opportunities <em style="font-size: 14px; text-transform:none; font-weight:300;"><br>
All dedications of $360 or more includes 2 guests • All dedications $1,000 or more includes 5 guests</em></div>
<div class="tablebg">
        <div class="columndiv">
          <div class="topgraybox">
            <div class="squaredFour"><input type="checkbox" value="None" id="Joining" name="Joining"> <label for="Joining"> </label></div>
<div class="checktext">
              <p class="topboxfont"><strong style="font-size: 20px;">Yes,</strong>
<br>
<em>we're looking forward to join the 10 Year Celebration and Torah Dedication Event</em></p>
            </div>
<div class="othercheck"><input type="checkbox" id="Couple" name="Joining: Couple"> <label for="Couple"><span> </span></label></div>
<div class="checktext">
              <p class="topboxfont"><strong>Couple:</strong> $180</p>
            </div>
<div class="othercheck"><input type="checkbox" id="Kids" name="Joining: Kids"> <label for="Kids"><span> </span></label></div>
<div class="checktext">
              <p class="topboxfont">No. of <strong>Kids</strong> <em>(Free)</em> <input name="Number of Children" type="number" id="Number of Children" style="width:50px;" max="20" min="1"></p>
            </div>
<div class="othercheck"><input type="checkbox" id="YJP" name="Joining: YJP"> <label for="YJP"><span> </span></label></div>
<div class="checktext">
              <p class="topboxfont"><strong>YJP</strong> $50</p>
            </div>
          </div>
<div class="topclearbox">
            <div class="othercheck"><input type="checkbox" id="$18Letter" name="$18Letter"> <label for="$18Letter"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>$18 Letter</strong>
<br>
Endow a letter in honor or in memory of a loved one.</p>
            </div>
<div class="othercheck"><input type="checkbox" id="$54Word" name="$54Word"> <label for="$54Word"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>$54 Word</strong>
<br>
Endow a word in honor or memory of a loved one.</p>
            </div>
<div class="othercheck"><input type="checkbox" id="$180Verse" name="$180Verse"> <label for="$180Verse"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>$180 Verse</strong>
<br>
Endow a verse in honor of your family or each member of the family.</p>
            </div>
<div class="othercheck"><input type="checkbox" id="$360Aliya" name="$360Aliya"> <label for="$360Aliya"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>$360 Aliya</strong>
<br>
Endow one Aliya of a Torah portion.</p>
            </div>
          </div>
<div class="middlegraybox">
            <div class="checktext">
              <p class="generalfont"><strong>$1,000 Yad</strong> - SPONSORED
<br>
<em>The beautiful Sterling Silver pointer prominently hung on the Torah.</em> </p>
            </div>
          </div>
<div class="middlegraybox">
            <div class="squaredFour"><input type="checkbox" value="None" id="$3600BreastPlate" name="$3600BreastPlate"> <label for="$3600BreastPlate"> </label></div>
<div class="checktext">
              <p class="generalfont"><strong>$3,600 Breast Plate</strong>
<br>
<em>The beautiful Sterling Silver Breast Plate, will be prominently displayed on the Torah.</em></p>
            </div>
          </div>
<div class="middleblackbox">
            <div class="squaredFour"><input type="checkbox" value="None" id="$36000TorahScroll" name="$36000TorahScroll"> <label for="$36000TorahScroll"> </label></div>
<div class="checktext">
              <p class="generalfont"><strong>$36,000 Torah Scroll</strong>
<br>
<em>Endow the entire Torah scroll.</em></p>
            </div>
          </div>
        </div>
<div class="columndiv">
          <div class="topgraybox">
            <div class="squaredFour"><input type="checkbox" value="None" id="NotAttending" name="Not Attending"> <label for="NotAttending"> </label></div>
<div class="checktext">
              <p class="topboxfont"><strong style="font-size: 20px;">Sorry,</strong>
<br>
<em>we will not be able to attend in person, but we would like to support the work of The Chai Center and participate in the Torah Dedication</em></p>
            </div>
          </div>
<div class="topclearbox">
            <div class="othercheck"><input type="checkbox" id="$1000Parsha" name="$1000Parsha"> <label for="$1000Parsha"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>$1,000 Parsha</strong> <em>(Weekly portion)</em>
<br>
Endow a weekly Torah portion of significance by choosing a Bar/Bat Mitzvah or wedding anniversary.</p>
<p class="generalfont">Please select which portion(s) you
<br>
would like to endow: <select name="Parsha Selection" id="Parsha Selection"><option value="Select">Select...</option>
                  <optgroup label="Bereishit-Genesis">
                    <option value="Bereishit">Bereishit</option>
                    <option value="Noach">Noach</option>
                    <option value="Lech Lecha">Lech Lecha</option>
                    <option value="Vayeira">Vayeira</option>
                    <option value="Chayei Sarah">Chayei Sarah</option>
                    <option value="Toldot">Toldot</option>
                    <option value="Vayeitzei">Vayeitzei</option>
                    <option value="Vayishlach">Vayishlach</option>
                    <option value="Vayeishev">Vayeishev</option>
                    <option value="Mikeitz">Mikeitz</option>
                    <option value="Vayigash">Vayigash</option>
                    <option value="Vayechi">Vayechi</option>
                  </optgroup>
                  <optgroup label="Shmot-Exodus">
                    <option value="Shemot">Shemot</option>
                    <option value="Va'eira">Va'eira</option>
                    <option value="Bo">Bo</option>
                    <option value="Beshalach">Beshalach</option>
                    <option value="Yitro">Yitro</option>
                    <option value="Mishpatim">Mishpatim</option>
                    <option value="Terumah">Terumah</option>
                    <option value="Tetzaveh">Tetzaveh</option>
                    <option value="Ki Tisa">Ki Tisa</option>
                    <option value="Vayakhel">Vayakhel</option>
                    <option value="Pekudei">Pekudei</option>
                  </optgroup>
                  <optgroup label="Vayikra-Leviticus">
                    <option value="Vayikra">Vayikra</option>
                    <option value="Tzav">Tzav</option>
                    <option value="Shemini">Shemini</option>
                    <option value="Tazria">Tazria</option>
                    <option value="Metzora">Metzora</option>
                    <option value="Acharei">Acharei</option>
                    <option value="Acharei">Acharei</option>
                    <option value="Emor">Emor</option>
                    <option value="Behar">Behar</option>
                    <option value="Bechukotai">Bechukotai</option>
                  </optgroup>
                  <optgroup label="Bamidbar-Numbers">
                    <option value="Bamidbar">Bamidbar</option>
                    <option value="Naso">Naso</option>
                    <option value="Behaalotecha">Behaalotecha</option>
                    <option value="Shelach">Shelach</option>
                    <option value="Korach">Korach</option>
                    <option value="Chukat">Chukat</option>
                    <option value="Balak">Balak</option>
                    <option value="Pinchas">Pinchas</option>
                    <option value="Matot">Matot</option>
                    <option value="Massei">Massei</option>
                  </optgroup>
                  <optgroup label="Devarim-Deuteronomy">
                    <option value="Devarim">Devarim</option>
                    <option value="Va'etchanan">Va'etchanan</option>
                    <option value="Eikev">Eikev</option>
                    <option value="Re'eh">Re'eh</option>
                    <option value="Shoftim">Shoftim</option>
                    <option value="Ki Teitzei">Ki Teitzei</option>
                    <option value="Ki Tavo">Ki Tavo</option>
                    <option value="Nitzavim">Nitzavim</option>
                    <option value="Vayelech">Vayelech</option>
                    <option value="Haazinu">Haazinu</option>
                    <option value="V'Zot HaBerachah">V'Zot HaBerachah</option>
                  </optgroup></select></p>
            </div>
<div class="othercheck"><input type="checkbox" id="OtherAmount" name="OtherAmount"> <label for="OtherAmount"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>Other Amount</strong>
<br>
Sponsor any amount towards the Torah writing.</p>
<p class="generalfont">Amount: <span class="topboxfont"><input type="number" name="Other Amount" id="Other Amount" style="width:50px;"></span></p>
            </div>
          </div>
<div class="middlegraybox">
            <div class="squaredFour"><input type="checkbox" value="None" id="$1800Mantel" name="$1800Mantel"> <label for="$1800Mantel"> </label></div>
<div class="checktext">
              <p class="generalfont"><strong>$1,800 Mantel</strong>
<br>
<em>The beautiful velvet Torah covering.</em></p>
            </div>
          </div>
<div class="middlegraybox">
            <div class="squaredFour"><input type="checkbox" value="None" id="$5400TorahCrown" name="$5400TorahCrown"> <label for="$5400TorahCrown"> </label></div>
<div class="checktext">
              <p class="generalfont"><strong>$5,400 Torah Crown</strong>
<br>
<em>The beautiful Sterling Silver Crown will be promimently displayed above the Torah.</em></p>
            </div>
          </div>
<div class="middleblackbox">
            <div class="squaredFour"><input type="checkbox" value="None" id="$5400BookofTorah" name="$5400BookofTorah"> <label for="$5400BookofTorah"> </label></div>
<div class="checktext">
              <p class="generalfont"><strong>$5,400 Book of Torah</strong>
<br>
<em>Endow one complete book of the Five Books of the Torah.</em></p>
            </div>
          </div>
        </div>
<div style="clear:both"> </div>
<fieldset>
          <legend>$1,800 Special Selections</legend> 
<p class="fieldsetintro">Endow a “Special Selection” in the Torah for your family or friend. Each of these are of special significance in that they possess central themes of faith, carrying unique blessings and inspiration.</p>
<div class="columnselections">
            <div class="othercheck"><input type="checkbox" id="AseresHadibros" name="AseresHadibros"> <label for="AseresHadibros"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>Aseres Hadibros</strong>
<br>
The Ten Commandments</p>
            </div>
<div class="othercheck"><input type="checkbox" id="ShemaYisrael" name="ShemaYisrael"> <label for="ShemaYisrael"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>Shema Yisrael</strong>
<br>
The portion of the Shema</p>
            </div>
<div class="othercheck"><input type="checkbox" id="HamalachHagoel" name="HamalachHagoel"> <label for="HamalachHagoel"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>Hamalach Hagoel</strong>
<br>
Blessings of Children</p>
            </div>
<div class="othercheck"><input type="checkbox" id="MaTovu" name="MaTovu"> <label for="MaTovu"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>Ma Tovu</strong>
<br>
The blessing extolling Israel's attributes of harmony and modesty.</p>
            </div>
<div class="othercheck"><input type="checkbox" id="BirchatKohanim" name="BirchatKohanim"> <label for="BirchatKohanim"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>Birchat Kohanim</strong>
<br>
The Priestly Blessings</p>
            </div>
<div class="othercheck"><input type="checkbox" id="ShirasHayam" name="ShirasHayam"> <label for="ShirasHayam"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>Shiras Hayam</strong>
<br>
The Song sung after the Splitting of the Sea</p>
            </div>
          </div>
<div class="columnselections">
            <div class="othercheck"><input type="checkbox" id="VayehiBinsoa" name="VayehiBinsoa"> <label for="VayehiBinsoa"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>Vayehi Binsoa</strong>
<br>
Prayer recited at opening of Ark</p>
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<div class="othercheck"><input type="checkbox" id="ShirasHabeer" name="ShirasHabeer"> <label for="ShirasHabeer"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>Shiras Habe’er</strong>
<br>
The Song of the Well</p>
            </div>
<div class="othercheck"><input type="checkbox" id="Manna" name="Manna"> <label for="Manna"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>Manna</strong>
<br>
The portion of the Manna – Blessings from Heaven</p>
            </div>
<div class="othercheck"><input type="checkbox" id="Chazak" name="Chazak"> <label for="Chazak"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>Chazak</strong> (5 available)
<br>
The final verse of each Book of Torah</p>
            </div>
<div class="othercheck"><input type="checkbox" id="HashemHashem" name="HashemHashem"> <label for="HashemHashem"><span> </span></label></div>
<div class="checktext">
              <p class="generalfont"><strong>Hashem Hashem</strong>
<br>
The 13 Attributes of Mercy</p>
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<div class="othercheck"><input type="checkbox" id="OtherSelection" name="OtherSelection"> <label for="OtherSelection"><span> </span></label></div>
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              <p class="generalfont"><strong>Other</strong>
<br>
Special Selection of your choice:
<br>
<span class="topboxfont"><input type="text" name="Other Special Selection" id="Other Special Selection" style="width:100px;"></span></p>
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<div style="clear:both;"> </div>
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          <tbody>
            <tr>
              <td width="24%" class="deetfield">Name</td>
              <td width="28%"><input type="text" name="Name" required="required" class="textgeneral" id="Name"></td>
              <td width="23%" class="deetfield">Total Amount</td>
              <td width="25%"><input type="number" name="x_amount" required="required" class="textgeneral" id="x_amount" placeholder="$0.00"></td>
            </tr>
<tr>
              <td bgcolor="#E7E7E8" class="deetfield">Address</td>
              <td bgcolor="#E7E7E8"><input type="text" name="Address" required="required" class="textgeneral" id="Address"></td>
              <td bgcolor="#E7E7E8"><span class="deetfield">Payment method</span></td>
              <td bgcolor="#E7E7E8"><select name="x_exp_month2"><option value="Select" selected>Select</option>
                  <option value="Check in the Mail">Check in the Mail</option>
                  <option value="Visa">Visa</option>
                  <option value="Mastercard">Mastercard</option>
                  <option value="American Express">American Express</option>
                  <option value="Discover">Discover</option></select></td>
            </tr>
<tr>
              <td class="deetfield">City, State &amp; Zip</td>
              <td>
                <div style="overflow: hidden; height: 24px;"><input type="text" name="x_city" required="required" class="textgeneral" id="x_city" placeholder="City" style="width: 78px;"> <input type="text" name="x_state" required="required" class="textgeneral" id="x_state" placeholder="State" style="width: 40px;"> <input type="text" name="x_zip" required="required" class="textgeneral" id="x_zip" placeholder="Zip" style="width: 60px;"></div>
              </td>
              <td><span class="deetfield">Card Number</span></td>
              <td><input type="text" name="x_card_num" class="textgeneral" id="x_card_num"></td>
            </tr>
<tr>
              <td bgcolor="#E7E7E8" class="textgeneral"><span class="deetfield">Phone</span></td>
              <td bgcolor="#E7E7E8"><input type="tel" name="Phone" required="required" class="textgeneral" id="Phone"></td>
              <td bgcolor="#E7E7E8"><span class="deetfield">Expiration</span></td>
              <td bgcolor="#E7E7E8"><select name="x_exp_month"><option value="" selected>--</option>
                  <option value="01">01</option>
                  <option value="02">02</option>
                  <option value="03">03</option>
                  <option value="04">04</option>
                  <option value="05">05</option>
                  <option value="06">06</option>
                  <option value="07">07</option>
                  <option value="08">08</option>
                  <option value="09">09</option>
                  <option value="10">10</option>
                  <option value="11">11</option>
                  <option value="12">12</option></select> <select name="x_exp_year" id="x_exp_year"><option value="" selected>----</option>
                  <option value="2015">2015</option>
                  <option value="2016">2016</option>
                  <option value="2017">2017</option>
                  <option value="2018">2018</option>
                  <option value="2019">2019</option>
                  <option value="2020">2020</option>
                  <option value="2021">2021</option>
                  <option value="2022">2022</option>
                  <option value="2023">2023</option>
                  <option value="2024">2024</option>
                  <option value="2025">2025</option>
                  <option value="2026">2026</option>
                  <option value="2027">2027</option>
                  <option value="2028">2028</option>
                  <option value="2029">2029</option>
                  <option value="2030">2030</option></select></td>
            </tr>
<tr>
              <td class="deetfield">Email</td>
              <td><input type="email" name="Email" required="required" class="textgeneral" id="Email"></td>
              <td><span class="deetfield">CVV Code</span></td>
              <td><input type="text" name="x_card_code" class="textgeneral" id="x_card_code"></td>
            </tr>
<tr>
              <td bgcolor="#E7E7E8" class="deetfield">comments / details</td>
              <td colspan="3" bgcolor="#E7E7E8"><textarea name="Comments" id="textarea" cols="45" rows="1"></textarea></td>
            </tr>
<tr>
              <td valign="top" colspan="4" class="included">Checks can be made payable and mailed to Chai Center • 105 S. Paul Street • Brookline, MA 02446</td>
            </tr>
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<p style="text-align: center;"><input type="submit" name="submit" class="rsvp" id="submit" value="Submit"></p>
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