Remember a Child Program Class or Group Participation Request

Classes or groups with a minimum of six participants must submit a Class or Group Participation form for each student. Each participant will be matched with a child Shoah victim and receive a Scroll of Remembrance certificate.

Submitted by*

First Last

Synagogue, Temple or School Name*

Position*

Administrator
Teacher
Clergy

Email*

Name of Parent or Guardian

First Last

Email of Parent or Guardian

Bar/Bat Mitzvah Information

Bat/Bar Mitzvah First Name (and optional middle name)*

Bat/Bar Mitzvah Last Name*

Hebrew Name*

First (and Middle) ben/bat

Celebration*

Bat Mitzvah
Bar Mitzvah

Mailing Address for certificate*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Bar/Bat Mitzvah*

Honoring the Memory of a Specific Child Victim

You are welcome to specify the hometown and/or country or origin of a child Holocaust victim. You also may provide information about a child Holocaust victim who was a member of the student's family or someone the student's family would like to remember or honor at the bar/ bat Mitzvah. Please enter his/her name, hometown or country of origin.

First Last

Victim

Hometown Country

Please share any additional relevant information or comments

Please allow a minimum of ONE MONTH to research information and prepare a certificate for each class or group member.

Each generous donation to The Generations After Remember a Child program enables us to continue the important work of remembering child victims of the Shoah. Program volunteers research multiple databases to identify an appropriate match and send links for continued research at home or in class, as well as create a beautiful certificate suitable for framing. We are able to continue the program and remember and honor child victims through the support of organizations like yours.

Additionally, after underwriting the expenses associated with running the RAC program, the remaining funds are channeled to support organizations that provide direct services to aging Holocaust survivors, including Blue Card.

Contributions for Remember a Child begin at $72 per certificate for individual requests. Groups or classes with six or more members may donate a minimum of $36 for each participant. Donations of $120, $90, $72 or more are greatly appreciated.

Generations After DC Inc. is a 501(c)3 tax-exempt organization, tax ID 521492115. Please consult a tax advisor to determine the deductibility of your contribution.

Donation Amount*

$120, $90, $72 or more is appreciated.

This is a payment for a*

Group
Individual

Billing Name*

First Last

Billing Information

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Billing Email*

Billing Phone*

Payment Information

Payment Method*

By credit card or PayPal
By check

If you are paying by check, please print the email confirmation you will receive after submitting this form and enclose it with a check made payable to "The Generations After." Mail it to: The Generations After, P.O. Box 2121, Rockville, MD 20847.

.

Would you like to cover the credit card convenience fee?

Yes - let me add a 2.5% contribution

Additional contribution to cover the credit card convenience fee

Price: $0.00

Total

$0.00

Upon submission, you will be taken to PayPal's website to enter your credit card information and complete your donation.