CK Membership renewal form 2022-23

Congregation Kehillah 2022/23 - 5782/83 Membership Renewal Form

Thank you for taking the time to fill out this renewal form.

It will ensure that our database is current and up-to-date.

Last name

Member #1 first name

Member #2 first name (if applicable)

Address

City

State

Zip

Home phone

Check box if no home phone

Cell number #1

Email #1

example@example.com

Email #2

example@example.com

Date of Birth #1

Date

Date of Birth #2

Date

Anniversary Date (if applicable)

Date

Emergency contact Name

Relationship

Cell Phone

Basic Membership Options

Family Membership (Two or more living in the same household) $2100 Young Adult Families (to age 36) $1150 Individual $1150 Young Adult Individual (to age 36) $675

The above fees include a Security Fee to help pay for security for all Congregation Kehillah onsite events including services and YEP!

Your membership runs from July 1, 2022 – June 30, 2023 and includes High Holy Day Tickets (for either in person service or a link to view them if needed) and YEP! for those with school age children.

No one is turned away due to financial hardship that precludes the ability to meet full dues commitments – we welcome you with open arms regardless of your financial situation!

You are welcome to contact us to discuss your individual situation and make special arrangements: (602) 369-7667 or info@congregationkehillah.org. All conversations are strictly confidential.

Kehillah Community Supporters (KCS)

Please consider becoming a KCS member, by checking one of the three categories listed below. We thank you for your support.

Kehillah Community Supporters (KCS) represent the financial pillars of our Kehillah (community), contributing beyond their basic membership commitment, helping to ensure our financial stability, safeguard our ability to retain staff, add additional clergy and staff as the need increases, and allow us to continue to deliver the high quality of care, programming, and services that you have come to know with Congregation Kehillah.

In addition, KCS helps to make certain that those who face financial challenges can still be members of our community, and those with children are able to raise them at Congregation Kehillah.

Kehillah Community Supporter Membership Options

Malach (Angel) $3600 Manhig (Leader) $2780 Shomer (Guardian) $2460

Your basic Membership Dues and Security Fee are included within the KCS program.

Please return your check by July 15, 2022 or choose another option below.

Congregation Kehillah, 21001 N Tatum Blvd, Ste 1630, #439, Phoenix, AZ 85050

Last name

Member #1 first name

Member #2 first name (if applicable)

I/We are paying the full dues amount now. Payment will be made by July 15, 2022. I/We choose to pay our dues half now and the second half by December 31, 2022. The first payment is enclosed. I/We choose to pay our dues quarterly beginning on July 15, 2022 and payments due on October 15, 2022; January 15 and April 15, 2023. The first payment is enclosed. I/We choose to set-up payments through the secure website,www.congregationkehillah.org, and understand that I/we will be charged an extra 3% to defray the credit card fees charged to Congregation Kehillah.

Signature

Clear

Date