Beit Ahavah Membership Form 2022-23 ~ 5783

Beit Ahavah Membership Form 2022-23 ~ 5783

Thank you for joining Beit Ahavah! Please complete this short two page form before submitting. Happy Summer! Welcome!
Name *

First Name Last Name
Pronouns
I am a: *

New Member Returning Member
Name(s) and pronouns of others in your household (please include ages if listing children): *
Write N/A if you are the only member in your household.
Email(s) *
Please separate multiple email addresses with commas.
Mailing Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
Alternate Phone Number

Area Code Phone Number
Getting involved ~ Explore community by bringing your talents as a leaders, volunteer, or committee member including for ideas, events, Shabbat services, Dreaming Up High Holydays, youth, families and teens, adult programming, Tzedek Tzedek social justice, Chesed caring committee, and more, and share your ideas and hopes. *

Yes, I am interested in learning more about volunteer/visioning/committee opportunities. At this time, I am not interested in volunteering or serving on a committee.
Are you interested in receiving Beit Ahavah Community updates and Highlights newsletter? *

I currently already receive the biweeklyHighlights and the community and rabbi’s emails. Yes, I would like to receive the Highlights. Please use the email addresses provided. Yes, I would like to receive the Highlights, but with a different email than what is provided. I am not interested in receiving the biweekly Highlights at this time.

Dues Contribution

Our fiscal year is July 1, 2022-June 30, 2023. Voluntary Membership dues are set at the top level by the Board, but are listed in a sliding scale range for different types of households and circumstances, and to accommodate those who cannot pay the top level at this time. Members who can afford higher than the suggested financial range are encouraged to contribute and write in your amount. Please contribute what you can to strengthen the community.

Category	Suggested Range
First Year (New Members)	$900-$1800
Second Year and Renewing Members	$1200-$2200
Dual Membership (paying dues to another synagogue)	$700-$1800
Student and Limited Income	$36-$360

Please write in your Dues amount below. *
Please enter in the format of $0/month or $0/year.
Beit Ahavah welcomes all community members, regardless of ability to pay. Your membership contribution is an investment in supporting the programs, services, staff and operating costs year-round. All payments and contributions to Beit Ahavah are 100% tax-deductible. Please select your preferences for dues contribution below. *

Contribute Annual amount in full Contribute Monthly (pay monthly for 12 months; withdrawals take place on or around the 15th of the month)
You can also invited to make a contribution to a synagogue fund, designated in honor or in memory of someone (such as to the General Fund, Klara Grape Memorial Music Fund, Rabbi's Discretionary Fund, Madison Ruth Meade Young Youth & Teen Education Fund, Leroy Seftel Adult Education Fund, or Tot Shabbat Fund).
Please confirm total due today: *
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Become a Sustaining Member (pay monthly) ( USD for each month )
This payment WILL renew automatically each MONTH.

Pay Membership Annually ( USD for each year )
This payment WILL renew automatically each YEAR.

One-time Membership Payment ( USD one-time payment)
This payment will NOT renew automatically. *PayPal will call this a "subscription" but it is a one-time payment and will not charge again.*

Pay by Check or Bank Transfer (Bill Me) ( Free for each month )
We will follow up with you to confirm payment type and amount.
I authorize Beit Ahavah to initiate payments using the selected method/account for the amounts listed on the dues form (either monthly or yearly). This authority will remain in effect until I cancel the preauthorized payment, which requires at least five (5) days written notice to the Beit Ahavah Treasurer before the next payment. *

I understand and agree.
You will be redirected to Paypal after clicking the submission button below. Please remain on the page to complete payment.
Thank you for being part of the Beit Ahavah community ~ Welcome!
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