Association of Hebrew Catholics

4120 W Pine Blvd St Louis MO 63108 USA (314) 535-4242 ahc@hebrewcatholic.org

The Association of Hebrew Catholics (AHC) is a voluntary association of Catholics of both Jewish and non-Jewish origins.
As a lay apostolate, the AHC is faithful to the teaching and discipline of the Magisterium.
We enlist the intercession of our patrons: Miriam, Our Lady of the Miracle, and St. Teresa Benedicta of the Cross (Edith Stein)

Affiliation / Subscription Form

Name ________________________________________________________________________________________________
Address ________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

Phone ___________________________

Email_____________________________________________________________

Mission: The AHC is a pastoral and educational work to preserve the identity and heritage of Israelites within the Church, helping
them to serve the Lord, His Church, and all peoples within the mystery of their irrevocable gifts and calling. (cf. Rom. 11:29)

We invite you to affiliate with the AHC as a Member, Supporter, or Friend.

Member:

an individual who is a member of the Catholic Church, faithful to the teaching and discipline of the Magisterium,
who supports the mission and work of the AHC, and
who agrees to regularly pray for our work.

Friend:

everyone else who supports and prays for the work of the AHC
(e.g., those who are not Catholic; those who do not wish to be identified as a member or supporter)

Supporter:

as above, but does not wish to be identified as a member

(e.g., members of certain religious orders are not allowed to be members of other organizations)

Please indicate below the affiliation you desire: (Note: All affiliates receive our publication, The Hebrew Catholic.)

Yourself:

Spouse:

___ Member

___ Supporter

___ Member

___ Friend

___ Supporter

___ Friend

___ Subscribe to The Hebrew Catholic for four issues without affiliating.

___ $15 US & Canada;
___ $25 all other countries

___ Check enclosed

___ Charge card info below

Affiliate Support

Contribution:

$____________

Pledge:

$____________

Total:

$____________

Note: Contributions may also be made through our web site ( http://www.hebrewcatholic.org )

per:

to be given by:

___ month

___ quarter

___ check/money order/cash

___ half-year

___ year

___ charge card (info below)

___ send reminders for check/money order pledges

The Association of Hebrew Catholics is a non-profit corporation. All contributions are tax deductible in accordance with 501(c)3 of the IRS code.

Charge card info:

() ___ American Express

() ___ Discover

() ___ Mastercard

() ___ Visa

Card no: ________________________________________________

Expiration (month year): ___________

Security code: ______ (3 or 4 numbers on back of card) Signed: ____________________________________________

Permission to Share Contact Information

We respect everyone's privacy and do not give out anyone's information without their permission. Even with permssion,
we do not respond to institutional, ideological, religious, or commercial requests for information. However, we would
like to help those who wish to make contact for conversation or prayer or a get together to develop a havurah, and so forth. If
you are willing to be contacted for these type of reasons, please indicate below the kind of contact information you are giving
us permission to share:

___ Address

___ Phone

___ Email

If you have checked off one or more contact items above, please indicate below if we may also share

___ your real name

___ the following pen name: ________________________________

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() ___ You may not give out any information about me.

Background

As the work of the AHC develops, it is important for us to understand the background of our affiliates and subscribers.
We would, therefore, appreciate your response below.

Yourself

Religion:

___ Catholic

___ Other baptized

Origin:

___ Jewish

___ Non-Jewish

Spouse

Religion:

___ Catholic

___ Other baptized

Origin:

___ Jewish

___ Non-Jewish

___ Judaism

___ *Other

___ Judaism

___ *Other

*Other (please indicate) ___________________________________________________________________________

Message ( Include name & address for gift subscription )

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