Make a Gala Payment/Donation

A high quality Jewish education is the best way to ensure the future of the Jewish people. Your gift will strengthen Robert M. Beren Academy which prepares our children to build the Jewish community of tomorrow and carry on the traditions that are close to your heart.

Please complete the following information. When you are finished, click Submit to enter your donation. Thank you for supporting Robert M. Beren Academy with your gift. If you need assistance, call 713-723-7170 or email rjacobson@berenacademy.org.

Contact Information
* Title:
* First Name:
* Last Name:
Maiden Name:
Spouse Title:
Spouse First Name:
Spouse Last Name:
* Address 1:
Address 2:
* City:
* State and Zip:
* Country:
		New Address
* Phone:
		Home Work Cell
* Email:
		An email confirmation will be sent to this address when your gift has been submitted.
Affiliation with RMBA:		Alumni Alumni Parent Faculty/Staff Parent Grandparent Other
Alumni/Alumnus Class Year(Optional):
Donation Information
		$25,000 Platinum (Table of 10) $18,000 Gold (Table of 10) $10,000 Silver (Table of 10) $ 5,400 Bronze (Table of 10) $ 3,600 Supporter (Half table - 5 seats) $ 1,000 Friend (2 seats) $ 275 Individual seat, number of seats $ 180 per Academy graduate or current RMBA student number of seats Unable to attend but I/we wish to make a scholarship donation *Total Payment/Donation Amount to be charged $ Please print your guests' names and dinner preferences (beef or fish):

	* Required Fields.