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			<h1 class="article-header__title js-article-title js-page-title">Journal/Sponsorship</h1>
		
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<form class="userform-form" action="" method="post" name="form_5832383" id="5832383" accept-charset="utf-8"><input type="hidden" name="formID" value="5832383" /><div class="form-all dir_ltr" dir="ltr"><ul class="form-section"><li class="form-line" id="id_33"><div class="form-label-left" id="label_33"><label for="input_33"> Sponsorship Opportunities<span class="form-required">*</span> </label><label class="label-message" for="input_33"> </label></div><div id="cid_33" class="form-input"> <div class="form-single-column"><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_33_0" name="q33_input33" value="Pillar of Chabad: $52,000***" /><label id="label_input_33_0" for="input_33_0"><span>Pillar of Chabad: $52,000***</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_33_1" name="q33_input33" value="Grand Master Builder $26,018***" /><label id="label_input_33_1" for="input_33_1"><span>Grand Master Builder $26,018***</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_33_2" name="q33_input33" value="Master Chaim Builder $ 18,018***" /><label id="label_input_33_2" for="input_33_2"><span>Master Chaim Builder $ 18,018***</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_33_3" name="q33_input33" value="Crown Page $ 10,018***" /><label id="label_input_33_3" for="input_33_3"><span>Crown Page $ 10,018***</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_33_4" name="q33_input33" value="Diamond Page $5,018***" /><label id="label_input_33_4" for="input_33_4"><span>Diamond Page $5,018***</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_33_5" name="q33_input33" value="Platinum Page $2,618**" /><label id="label_input_33_5" for="input_33_5"><span>Platinum Page $2,618**</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_33_6" name="q33_input33" value="Chai Page $1,800**" /><label id="label_input_33_6" for="input_33_6"><span>Chai Page $1,800**</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_33_7" name="q33_input33" value="Gold Page $ 1,518**" /><label id="label_input_33_7" for="input_33_7"><span>Gold Page $ 1,518**</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_33_8" name="q33_input33" value="Silver Page $1,360**" /><label id="label_input_33_8" for="input_33_8"><span>Silver Page $1,360**</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_33_9" name="q33_input33" value="Full Page: $1,018**" /><label id="label_input_33_9" for="input_33_9"><span>Full Page: $1,018**</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_33_10" name="q33_input33" value="Half Page: $770**" /><label id="label_input_33_10" for="input_33_10"><span>Half Page: $770**</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_33_11" name="q33_input33" value="Quarter Page: $360*" /><label id="label_input_33_11" for="input_33_11"><span>Quarter Page: $360*</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_33_12" name="q33_input33" value="Eighth of a Page: $180" /><label id="label_input_33_12" for="input_33_12"><span>Eighth of a Page: $180</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio-other form-radio validate[required, other]" name="q33_input33" id="other_33" value="" /><span><input type="text" form-radio="" class="form-radio-other-input form-textbox " name="q33_input33[other]" data-otherhint="Other" size="15" id="input_33" disabled="disabled" /></span><br /></span></div> </div></li><li class="form-line" id="id_27"><div id="cid_27" class="form-input-wide"> <div id="text_27" class="form-html"><p>*includes entrance for 1<br />**includes entrance for 2<br />*** includes entrance for 10</p></div> </div></li><li class="form-line" id="id_36"><div class="form-label-left" id="label_36"><label for="input_36"> In Honor of </label><label class="label-message" for="input_36"> </label></div><div id="cid_36" class="form-input"> <div class="form-single-column"><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_36_0" name="q36_input36[]" value="Mr. Payman &amp; Niloo Yadidi  &amp;  Mr. Pajman &amp; Negin Yadidi and families, Dor L’Dor, Generation Award -  In honor of Parivash Yadidi &amp; In memory of Mr. Firooz Yadidi a”h" /><label id="label_input_36_0" for="input_36_0"><span>Mr. Payman &amp; Niloo Yadidi  &amp;  Mr. Pajman &amp; Negin Yadidi and families, Dor L’Dor, Generation Award -  In honor of Parivash Yadidi &amp; In memory of Mr. Firooz Yadidi a”h</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_36_1" name="q36_input36[]" value="Kamy &amp; Yaffa  Haimof, Lamplighter Award" /><label id="label_input_36_1" for="input_36_1"><span>Kamy &amp; Yaffa  Haimof, Lamplighter Award</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_36_2" name="q36_input36[]" value="Eddie and Vanessa  Eliahu, Hebrew School Parents of the Year" /><label id="label_input_36_2" for="input_36_2"><span>Eddie and Vanessa  Eliahu, Hebrew School Parents of the Year</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_36_3" name="q36_input36[]" value="Natela &amp; Uri Pinhasov, Eitz Chayim-Tree of Life Award" /><label id="label_input_36_3" for="input_36_3"><span>Natela &amp; Uri Pinhasov, Eitz Chayim-Tree of Life Award</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_36_4" name="q36_input36[]" value="Veronique Hadjibay, Gift of Giving Intl Chessed Award" /><label id="label_input_36_4" for="input_36_4"><span>Veronique Hadjibay, Gift of Giving Intl Chessed Award</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_36_5" name="q36_input36[]" value="Albert &amp; Edna Khalily, Outstanding  Educator Award" /><label id="label_input_36_5" for="input_36_5"><span>Albert &amp; Edna Khalily, Outstanding  Educator Award</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_36_6" name="q36_input36[]" value="Mazi Pilip, NC Legislator, Special Guest" /><label id="label_input_36_6" for="input_36_6"><span>Mazi Pilip, NC Legislator, Special Guest</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox" id="input_36_7" name="q36_input36[]" value="Rabbi Dovid &amp; Chumy Ezagui, Lake Success Chabad" /><label id="label_input_36_7" for="input_36_7"><span>Rabbi Dovid &amp; Chumy Ezagui, Lake Success Chabad</span></label></span><span class="clearfix"></span></div> </div></li><li id="cid_29" class="form-input-wide"> <div class="form-header-group"><h2 id="header_29" class="form-header">Journal Ad</h2></div> </li><li class="form-line" id="id_31"><div class="form-label-left" id="label_31"><label for="input_31"> Dedication ad text </label><label class="label-message" for="input_31"> </label></div><div id="cid_31" class="form-input"> <textarea id="input_31" class="form-textarea" name="q31_input31" cols="40" rows="6"></textarea> </div></li><li class="form-line" id="id_32"><div class="form-label-left" id="label_32"><label for="input_32"> Your name how you would like it to appear on the ad </label><label class="label-message" for="input_32"> </label></div><div id="cid_32" class="form-input"> <input type="text" class=" form-textbox" data-type="input-textbox" id="input_32" name="q32_input32" size="20" value="" /> </div></li><li class="form-line" id="id_35"><div id="cid_35" class="form-input-wide"> <div id="text_35" class="form-html"><p>If you have any questions email ChabadLakeSuccess@gmail.com</p></div> </div></li><li id="cid_34" class="form-input-wide"> <div class="form-header-group"><h2 id="header_34" class="form-header">Personal Info</h2></div> </li><li class="form-line" id="id_1"><div class="form-label-left" id="label_1"><label for="input_1"> Your Name<span class="form-required">*</span> </label><label class="label-message" for="input_1"> </label></div><div id="cid_1" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q1_fullName[first]" id="first_1" autocomplete="given-name" />  <label class="form-sub-label" for="first_1" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q1_fullName[last]" id="last_1" autocomplete="family-name" />  <label class="form-sub-label" for="last_1" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_5"><div class="form-label-left" id="label_5"><label for="input_5"> Address<span class="form-required">*</span> </label><label class="label-message" for="input_5"> </label></div><div id="cid_5" class="form-input"> <table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-line" type="text" name="q5_address[addr_line1]" id="input_5_addr_line1" size="46" autocomplete="address-line1" />  <label class="form-sub-label" for="input_5_addr_line1" id="sublabel_5_addr_line1">Street Address</label></span></td></tr><tr style="display: none;"><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line no-validation" type="text" name="q5_address[addr_line2]" id="input_5_addr_line2" size="46" autocomplete="address-line2" />  <label class="form-sub-label" for="input_5_addr_line2" id="sublabel_5_addr_line2">Street Address Line 2</label></span></td></tr><tr><td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-city" type="text" name="q5_address[city]" id="input_5_city" size="21" autocomplete="address-level2" />  <label class="form-sub-label" for="input_5_city" id="sublabel_5_city">City</label></span></td><td><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-state" type="text" name="q5_address[state]" id="input_5_state" size="22" autocomplete="address-level1" />  <label class="form-sub-label" for="input_5_state" id="sublabel_5_state">State / Province</label></span></td></tr><tr><td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-postal" type="text" name="q5_address[postal]" id="input_5_postal" size="10" autocomplete="postal-code" />  <label class="form-sub-label" for="input_5_postal" id="sublabel_5_postal">Postal / Zip Code</label></span></td><td style="display: none;"><span class="form-sub-label-container"><select class="form-dropdown validate[required] form-address-country" name="q5_address[country]" id="input_5_country" autocomplete="country-name"><option value="" selected="selected">Please Select</option><option value="United States">United States</option><option value="Afghanistan">Afghanistan</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="American Samoa">American Samoa</option><option value="Andorra">Andorra</option><option value="Angola">Angola</option><option value="Anguilla">Anguilla</option><option value="Antigua and Barbuda">Antigua and Barbuda</option><option value="Argentina">Argentina</option><option value="Armenia">Armenia</option><option value="Aruba">Aruba</option><option value="Australia">Australia</option><option value="Austria">Austria</option><option value="Azerbaijan">Azerbaijan</option><option value="The Bahamas">The Bahamas</option><option value="Bahrain">Bahrain</option><option value="Bangladesh">Bangladesh</option><option value="Barbados">Barbados</option><option value="Belarus">Belarus</option><option value="Belgium">Belgium</option><option value="Belize">Belize</option><option value="Benin">Benin</option><option value="Bermuda">Bermuda</option><option value="Bhutan">Bhutan</option><option value="Bolivia">Bolivia</option><option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option><option value="Botswana">Botswana</option><option value="Brazil">Brazil</option><option value="Brunei">Brunei</option><option value="Bulgaria">Bulgaria</option><option value="Burkina Faso">Burkina Faso</option><option value="Burundi">Burundi</option><option value="Cambodia">Cambodia</option><option value="Cameroon">Cameroon</option><option value="Canada">Canada</option><option value="Cape Verde">Cape Verde</option><option value="Cayman Islands">Cayman Islands</option><option value="Central African Republic">Central African Republic</option><option value="Chad">Chad</option><option value="Chile">Chile</option><option value="People's Republic of China">People's Republic of China</option><option value="Republic of China">Republic of China</option><option value="Christmas Island">Christmas Island</option><option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option><option value="Colombia">Colombia</option><option value="Comoros">Comoros</option><option value="Congo">Congo</option><option value="Cook Islands">Cook Islands</option><option value="Costa Rica">Costa Rica</option><option value="Cote d'Ivoire">Cote d'Ivoire</option><option value="Croatia">Croatia</option><option value="Cuba">Cuba</option><option value="Cyprus">Cyprus</option><option value="Czech Republic">Czech Republic</option><option value="Denmark">Denmark</option><option value="Djibouti">Djibouti</option><option value="Dominica">Dominica</option><option value="Dominican Republic">Dominican Republic</option><option value="Ecuador">Ecuador</option><option value="Egypt">Egypt</option><option value="El Salvador">El Salvador</option><option value="Equatorial Guinea">Equatorial Guinea</option><option value="Eritrea">Eritrea</option><option value="Estonia">Estonia</option><option value="Eswatini">Eswatini</option><option value="Ethiopia">Ethiopia</option><option value="Falkland Islands">Falkland Islands</option><option value="Faroe Islands">Faroe Islands</option><option value="Fiji">Fiji</option><option value="Finland">Finland</option><option value="France">France</option><option value="French Polynesia">French Polynesia</option><option value="Gabon">Gabon</option><option value="The Gambia">The Gambia</option><option value="Georgia">Georgia</option><option value="Germany">Germany</option><option value="Ghana">Ghana</option><option value="Gibraltar">Gibraltar</option><option value="Greece">Greece</option><option value="Greenland">Greenland</option><option value="Grenada">Grenada</option><option value="Guadeloupe">Guadeloupe</option><option value="Guam">Guam</option><option value="Guatemala">Guatemala</option><option value="Guernsey">Guernsey</option><option value="Guinea">Guinea</option><option value="Guinea-Bissau">Guinea-Bissau</option><option value="Guyana">Guyana</option><option value="Haiti">Haiti</option><option value="Honduras">Honduras</option><option value="Hong Kong">Hong Kong</option><option value="Hungary">Hungary</option><option value="Iceland">Iceland</option><option value="India">India</option><option value="Indonesia">Indonesia</option><option value="Iran">Iran</option><option value="Iraq">Iraq</option><option value="Ireland">Ireland</option><option value="Israel">Israel</option><option value="Italy">Italy</option><option value="Jamaica">Jamaica</option><option value="Japan">Japan</option><option value="Jersey">Jersey</option><option value="Jordan">Jordan</option><option value="Kazakhstan">Kazakhstan</option><option value="Kenya">Kenya</option><option value="Kiribati">Kiribati</option><option value="North Korea">North Korea</option><option value="South Korea">South Korea</option><option value="Kosovo">Kosovo</option><option value="Kuwait">Kuwait</option><option value="Kyrgyzstan">Kyrgyzstan</option><option value="Laos">Laos</option><option value="Latvia">Latvia</option><option value="Lebanon">Lebanon</option><option value="Lesotho">Lesotho</option><option value="Liberia">Liberia</option><option value="Libya">Libya</option><option value="Liechtenstein">Liechtenstein</option><option value="Lithuania">Lithuania</option><option value="Luxembourg">Luxembourg</option><option value="Macau">Macau</option><option value="Macedonia">Macedonia</option><option value="Madagascar">Madagascar</option><option value="Malawi">Malawi</option><option value="Malaysia">Malaysia</option><option value="Maldives">Maldives</option><option value="Mali">Mali</option><option value="Malta">Malta</option><option value="Marshall Islands">Marshall Islands</option><option value="Martinique">Martinique</option><option value="Mauritania">Mauritania</option><option value="Mauritius">Mauritius</option><option value="Mayotte">Mayotte</option><option value="Mexico">Mexico</option><option value="Micronesia">Micronesia</option><option value="Moldova">Moldova</option><option value="Monaco">Monaco</option><option value="Mongolia">Mongolia</option><option value="Montenegro">Montenegro</option><option value="Montserrat">Montserrat</option><option value="Morocco">Morocco</option><option value="Mozambique">Mozambique</option><option value="Myanmar">Myanmar</option><option value="Namibia">Namibia</option><option value="Nauru">Nauru</option><option value="Nepal">Nepal</option><option value="Netherlands">Netherlands</option><option value="New Caledonia">New Caledonia</option><option value="New Zealand">New Zealand</option><option value="Nicaragua">Nicaragua</option><option value="Niger">Niger</option><option value="Nigeria">Nigeria</option><option value="Niue">Niue</option><option value="Norfolk Island">Norfolk Island</option><option value="Northern Mariana">Northern Mariana</option><option value="Norway">Norway</option><option value="Oman">Oman</option><option value="Pakistan">Pakistan</option><option value="Palau">Palau</option><option value="Panama">Panama</option><option value="Papua New Guinea">Papua New Guinea</option><option value="Paraguay">Paraguay</option><option value="Peru">Peru</option><option value="Philippines">Philippines</option><option value="Pitcairn Islands">Pitcairn Islands</option><option value="Poland">Poland</option><option value="Portugal">Portugal</option><option value="Puerto Rico">Puerto Rico</option><option value="Qatar">Qatar</option><option value="Romania">Romania</option><option value="Russia">Russia</option><option value="Rwanda">Rwanda</option><option value="Saint Barthelemy">Saint Barthelemy</option><option value="Saint Helena">Saint Helena</option><option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option><option value="Saint Lucia">Saint Lucia</option><option value="Saint Martin">Saint Martin</option><option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option><option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option><option value="Samoa">Samoa</option><option value="San Marino">San Marino</option><option value="Sao Tome and Principe">Sao Tome and Principe</option><option value="Saudi Arabia">Saudi Arabia</option><option value="Senegal">Senegal</option><option value="Serbia">Serbia</option><option value="Seychelles">Seychelles</option><option value="Sierra Leone">Sierra Leone</option><option value="Singapore">Singapore</option><option value="Slovakia">Slovakia</option><option value="Slovenia">Slovenia</option><option value="Solomon Islands">Solomon Islands</option><option value="Somalia">Somalia</option><option value="Somaliland">Somaliland</option><option value="South Africa">South Africa</option><option value="South Ossetia">South Ossetia</option><option value="Spain">Spain</option><option value="Sri Lanka">Sri Lanka</option><option value="Sudan">Sudan</option><option value="Suriname">Suriname</option><option value="Svalbard">Svalbard</option><option value="Sweden">Sweden</option><option value="Switzerland">Switzerland</option><option value="Syria">Syria</option><option value="Taiwan">Taiwan</option><option value="Tajikistan">Tajikistan</option><option value="Tanzania">Tanzania</option><option value="Thailand">Thailand</option><option value="Timor-Leste">Timor-Leste</option><option value="Togo">Togo</option><option value="Tokelau">Tokelau</option><option value="Tonga">Tonga</option><option value="Trinidad and Tobago">Trinidad and Tobago</option><option value="Tristan da Cunha">Tristan da Cunha</option><option value="Tunisia">Tunisia</option><option value="Turkey">Turkey</option><option value="Turkmenistan">Turkmenistan</option><option value="Turks and Caicos Islands">Turks and Caicos Islands</option><option value="Tuvalu">Tuvalu</option><option value="Uganda">Uganda</option><option value="Ukraine">Ukraine</option><option value="United Arab Emirates">United Arab Emirates</option><option value="United Kingdom">United Kingdom</option><option value="Uruguay">Uruguay</option><option value="Uzbekistan">Uzbekistan</option><option value="Vanuatu">Vanuatu</option><option value="Vatican City">Vatican City</option><option value="Venezuela">Venezuela</option><option value="Vietnam">Vietnam</option><option value="British Virgin Islands">British Virgin Islands</option><option value="US Virgin Islands">US Virgin Islands</option><option value="Wallis and Futuna">Wallis and Futuna</option><option value="Western Sahara">Western Sahara</option><option value="Yemen">Yemen</option><option value="Zambia">Zambia</option><option value="Zimbabwe">Zimbabwe</option><option value="other">Other</option></select>  <label class="form-sub-label" for="input_5_country" id="sublabel_5_country">Country</label></span></td></tr></tbody></table> </div></li><li class="form-line" id="id_3"><div class="form-label-left" id="label_3"><label for="input_3"> E-mail<span class="form-required">*</span> </label><label class="label-message" for="input_3"> </label></div><div id="cid_3" class="form-input"> <input type="email" class=" form-textbox validate[required, Email]" id="input_3" name="q3_email" size="30" value="" autocomplete="email" /> </div></li><li class="form-line" id="id_4"><div class="form-label-left form-label-hidden" id="label_4"></div><div id="cid_4" class="form-input"> <div class="form-single-column form-checkbox-item"><input name="optin" value="true" type="checkbox" checked="checked" class="form-checkbox" id="input_4" /><label id="label_input_4" for="input_4">I would like to receive news and updates by email</label></div> </div></li><li class="form-line" id="id_6"><div class="form-label-left" id="label_6"><label for="input_6"> Best number to reach you at<span class="form-required">*</span> </label><label class="label-message" for="input_6"> </label></div><div id="cid_6" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q6_phoneNumber[area]" id="input_6_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_6_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, 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