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Membership Commitment 2024-2025
Please verify reCaptcha before submitting the form.
ADULT 1 INFORMATION
*
First Name
Middle Name
*
Last Name
Maiden Name
if applicable
*
Birthdate (MM/DD/YYYY):
*
Gender
Please Select One
Female
Male
Other/Non-binary
*
Pronouns
Email
*
Cell
Hebrew Name
Father's Hebrew Name
Mother's Hebrew Name
*
Tribe at Birth
Please Select One
Kohen
Levi
Yisrael
Jew by Choice
Is there a second adult applying for Membership?
Please Select One
Yes
No
ADULT 2 INFORMATION
*
First Name
Middle Name
*
Last Name
Maiden Name
if applicable
*
Birthdate (MM/DD/YYYY):
*
Gender
Please Select One
Female
Male
Other/Non-binary
*
Pronouns
Hebrew Name
Father's Hebrew Name
Mother's Hebrew Name
*
Tribe at Birth
Please Select One
Kohen
Levi
Yisrael
Jew by Choice
HOUSEHOLD INFORMATION
*
Address Line 1
Apt./Suite
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip
Membership Commitment
*
Select Membership Commitment
Please Select One
Joshua Society - Pillars of TBS: $50,000+
Joshua Society - Circle of Guardians: $36,000+
Joshua Society - Circle of Builders: $25,000+
Joshua Society - Circle of Founders: $18,000+
Joshua Society - Circle of Heroes: $10,000+
Joshua Society - Circle of Benefactors: $7,200+
Joshua Society - Circle of Friends: $5,400+
Family Membership Commitment: $3,400+
Single Membership (with school age kids): $2,600
Single Membership Commitment: $1,800
Associate/Non-Resident: $1000
I will discuss my 2024-2025 Membership Commitment with the Executive Director.
*Associate/Non-Resident Membership Commitment is for those who wish to support and maintain connection with Temple Beth Sholom and are members in good standing at another synagogue or have moved 25 miles or more away from the area. Each year, you will be asked to provide a letter from the other synagogue.
**For more information on the Joshua Society,
click here
.
*
I/We agree tp [ay the $500 Security Fee.
I/We agree tp [ay the $500 Security Fee.
*
IT IS UNDERSTOOD AND AGREED THAT YOUR MEMBERSHIP WILL AUTOMATICALLY BE RENEWED EACH YEAR UNLESS A NOTICE OF TERMINATION IS RECEIVED IN WRITING AT LEAST THIRTY (30) DAYS PRIOR TO THE RENEWAL YEAR ON JULY 1.
IT IS UNDERSTOOD AND AGREED THAT YOUR MEMBERSHIP WILL AUTOMATICALLY BE RENEWED EACH YEAR UNLESS A NOTICE OF TERMINATION IS RECEIVED IN WRITING AT LEAST THIRTY (30) DAYS PRIOR TO THE RENEWAL YEAR ON JULY 1.
Total:
Tue, August 20 2024 16 Av 5784