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	Support Us -  Chabad of NW Bergen County
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		<div width="100%" class="cco_templateless_template" style="z-index:100 !important;display:block !important;left:0px !important;top:0px !important;height:30px!important;width:100% !important;line-height:30px !important; position:relative !important; margin-bottom:0 !important; padding:0;text-indent: 25px;" align="Left"><a href="//www.ChabadPlace.org" style="display:block!important;font-size:14px !important;">&laquo; Back to&nbsp; Chabad of NW Bergen County</a></div>
	
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<span style="font-size: 36px; color: rgb(156, 74, 239); font-family: tahoma;">The&#160;</span>
<span style="font-size: 36px; color: rgb(156, 74, 239); font-family: tahoma;">Friendship&#160;Circle</span></strong>
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<img src="https://w2.chabad.org/images/shluchim/minisites/themes/friendship_circle/friendship_text_head.png" real_width="295" real_height="101" border="0" align="middle" /></p></td></tr></tbody></table></div>

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<a href="/article.asp?aid=1321543" class="parent">Home</a>
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<a href="/article.asp?aid=855678">Friendship Club Video</a>
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<a href="/article.asp?aid=825778">Completing the Circle</a>
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			<div class="clearfix bh mobile-only align_right">ב"ה</div>
			
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			<h1 class="article-header__title js-article-title js-page-title">Support Us</h1>
		
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<strong>                        Support a Child with Special Needs!</strong></p>
<p align="justify">The Friendship Circle extends a Helping hand to families who have children with special needs and involves them in a full range of social and Judaic experiences. The Circle introduces teenage volunteers to the children and their families, and all are enriched through the shared experiences. The volunteers learn the value of giving, and the child's family gets to see their child become a part of the community. Together, we form a seamless circle of friendship. Together, we can perform miracles.
<table cellspacing="0" cellpadding="2" width="663" align="center" border="0">
<tbody>
<tr>
<td width="32%" height="15">Last Name</td>
<td width="68%" height="15">
<input tabindex="1" size="26" required="true" name="Name" type="text"></td>
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<tr>
<td width="32%" height="15">First Name</td>
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<td height="15"></td>
<td height="15"></td>
</tr>
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<td width="32%" height="15"><input tabindex="7" type="radio" name="Founders Club" value="$18,000.00"><strong>Founders Club</strong> - <em>$18,000.00</em></td>
<td width="68%" height="15"><input tabindex="10" type="radio" name="FC Partner" value="$2,600.00"><strong>Friendship Circle Partner</strong> - <em>$2,600.00</em></td>
</tr>
<tr>
<td width="32%" height="15"><input tabindex="8" type="radio" name="FC Pillars" value="$10,000.00"><strong>Friendship Circle Pillar</strong> - <em>$10,000.00</em></td>
<td width="68%" height="15"><input tabindex="11" type="radio" name="FC Chai" value="$1,800.00"><strong>Friendship Circle Chai</strong> - <em>$1,800.00</em></td>
</tr>
<tr>
<td width="32%" height="15"><input tabindex="9" type="radio" name="FC Patron" value="$5,000.00"><strong>Friendship Circle Patron</strong> - <em>$5,000.00</em></td>
<td width="68%" height="15">
<p>
<font face="Arial" color="#333399"><input tabindex="12" type="radio" name="Other" value="other"><strong>Other</strong>                                                 <input tabindex="13" size="21" required="false" name="Other Amnt" type="text">             </font>
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<strong> Method of Payment:</strong></td>
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<tr>
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<td width="68%" height="15">
<input tabindex="17" size="29" required="true" name="Card Number" type="text"></td>
</tr>
<tr>
<td width="32%" height="15">Exp. date:</td>
<td width="68%" height="15">
<input tabindex="18" size="29" required="true" name="Expiration Date" type="text"></td>
</tr>
<tr>
<td width="32%" height="15">Amount:</td>
<td width="68%" height="15">
<input tabindex="19" size="29" required="true" name="Amount" value="$" type="text"></td>
</tr>
<tr>
<td height="15"></td>
<td height="15"></td>
</tr>
<tr>
<td height="15" colspan="2"><strong>Mark this donation in memory or in honor of your loved one</strong> <em>(optional)</em></td>
</tr>
<tr>
<td height="15" colspan="2">
<em>Yes, I'd like to mark this donation                   <input tabindex="20" type="radio" name="In memory of" value="on">                   in memory /                   <input tabindex="21" type="radio" name="in honor of" value="on">           in honor of:</em></td>
</tr>
<tr>
<td width="32%" height="15">First Name:</td>
<td width="68%" height="15">
<strong><input tabindex="22" size="30" required="false" name="donation made in honor of (1st name)" type="text"></strong></td>
</tr>
<tr>
<td width="32%" height="15">Last Name:</td>
<td width="68%" height="15">
<strong><input tabindex="23" size="30" required="false" name="donation made in honor of (last name)" type="text"></strong></td>
</tr>
<tr>
<td width="32%" height="15">
<p>Hebrew Name:</p>
</td>
<td width="68%" height="15">
<strong><input tabindex="24" size="30" required="false" name="donation made in honor of (hebrew name)" type="text"></strong></td>
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<tr>
<td width="32%" height="15">Relationship:</td>
<td width="68%" height="15">
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<tr>
<td width="32%" height="15">Comments:</td>
<td></td>
</tr>
</tbody>
</table>
</p>

<p align="center">
<strong>
<em><font face="Arial" color="#333399">Thank you for being our partner!</font></em></strong></p>
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