Temple Beth Sholom High Holiday & Membership Form
Your Information
Name
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First Name
Last Name
Partner/Spouse
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Last Name
Email
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example@example.com
Phone Number
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Area Code
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Mailing Address
Street Address
Street Address Line 2
City
State / Province
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Amount
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Membership - Individual
All applications for membership are subject to the approval of the temple board of directors.
$900.00
$
900.00
Membership - Family
All applications for membership are subject to the approval of the temple board of directors.
$1,500.00
$
1,500.00
Debit or Credit Card
First Name
Last Name
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Expiration Month
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February
March
April
May
June
July
August
September
October
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Expiration Month
Expiration Year
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2030
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2033
2034
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2045
Expiration Year
This donation is:
in Honor of
in Memory of
in Appreciation of
Name(s):
Send an acknowledgment of this donation to:
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please accept my payment towards the following: (Yes, you can choose more than one):
*
Membership Dues
High Holidays Tickets
Yizkor Book
Yahrzeit
Rabbi’s Discretionary Fund
General Donation
Other
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