Name: _____________________________________________________________________________________________________________________
Address: ___________________________________________________________________________________________________________________
City, State, Zip: ___________________________________________________________________________________________________________
Home Phone: ________________________________________________ Cell Phone: ________________________________________________
E-mail: ______________________________________________________________________________________________________________________
Please list my name as: ____________________________________________________________________________________________________
Solicited By: ________________________________________________________________________________________________________________
JOIN YOUR FRIENDS AND BE A PART OF THE LEWIS JCC FISCAL YEAR 2026 WALL OF GIVING
LEADER $5,200
TRUSTEE $10,000
FOUNDER $18,000
GUARDIAN $25,000
BENEFACTOR $3,200
PILLAR $1,200
PATRON $1,800
SPONSOR $900
PROGRAM FRIEND $720
FRIEND OF THE JCC $450
Same as Leader plus one $1,800 donation toward
JCC Financial Assistance Program, $1800 ad in
the Founders Journal (Total value $5,025)*
Same as Founder plus entrance to all JCC
programs and events (Total value TBD)*
Same as Trustee plus Festival of Arts, Books & Culture
and International Jewish Film Festival event sponsorship
(Total value $8,030)*
(2) One-Day Passes to Russin Fitness & Wellness Center; One
year Family Russin Fitness & Wellness Center Membership;
$1000 ad in the Founders Journal (Total value $2,425)*
(2) One-Day Passes to Russin Fitness & Wellness Center; One
year Family Russin Fitness & Wellness Center Membership;
$500 ad in the Founders Journal (Total value $1,925)*
(2) One-Day Passes to Russin Fitness & Wellness
Center; $400 toward your Russin Fitness & Wellness
Center Membership (Total value $430)*
(2) One-Day Passes to Russin Fitness & Wellness
Center; $300 toward your Russin Fitness & Wellness
Center Membership (Total value $330)*
Community Membership up to $265; (2) One-Day Passes
to Russin Fitness & Wellness Center (Total value $295)*
Community Membership up to $265; (2) One-Day Passes
to Russin Fitness & Wellness Center (Total value $295)*
(2) One-Day Passes to Russin Fitness & Wellness Center;
Free Individual Russin Fitness & Wellness Center
Membership (Total value $825)*
FISCAL YEAR 2026 WALL OF GIVING
I choose no benefits and want the full tax deduction*
Please use my name from last year
I have enclosed a check in the amount of $________________ made payable to the Lewis JCC
I would like to make a donation in the amount of $________________
Amex
Credit Card #: ______________________________________________________Exp. Date: ____________________Code: __________________
Name on Card:_________________________________________________________Signature:__________________________________________
The minimum donation for recognition on the wall is
$450. * For your donation to have the greatest impact,
please select the “I choose no benefits” option.
LEWIS JCC
450 WEST NYACK ROAD
WEST NYACK, NY 10994
845.362.4400
lewisjcc.org
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