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    Beth Shalom New Member Form

  • Welcome to Beth Shalom!  We are delighted that you and your family are joining our family!  Please complete and submit this form.  If you have questions, please email the office or call the office at 919-858-7777.

    At Beth Shalom, we do not turn anyone away for financial reasons.  We first and foremost value each person as a member of our family and prioritize our mission to provide a community where adults, families, and youth can form connections with each other and their Judaism.  This form, however, does provide suggested membership dues to help families in their determination of their contribution. If you cannot afford the suggested dues, please indicate so on this form and someone will be in contact with you.

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    Family Information 

  • Household Information

  • Adults in the Household

    Please list all adults who live in the household including adult dependents such as college students.  Adult 1 will be considered the primary contact for the household whose email will be used to send electronic statements.

  • Adult 1: Primary Contact

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  • Adult 2

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  • Adult 3

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  • Adult 4

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  • Children & Teens in the Household

    Please list all children, middle schoolers, and high schoolers that reside in the household. 

  • Religious School & Teen Programs

    For parents of children in pre-kindergarten through the 7th grade, we hope you will enroll your child(ren) in our Religious School.  In addition, all middle and high schoolers are automatically enrolled in our Teen Program, which includes: Jr. BeShTy, our youth group for middle schoolers; Sr. BeShTy, our youth group for high schoolers; and the Madrichim program in which our high schoolers have the opportunity to help out in the religious school.  For more information about our Religious School and Teen Programs, please email Rabbi Edery or call the office at 919-858-7777.  

    Below are the current Religious School fees.  For families with a teen in grades eight through twelve, a teen program fee of $120.00 also applies.  Sixth and seventh graders are also enrolled in our teen programs; the Teen Program fee of $120.00 is waived if the sixth or seventh grader is enrolled in our Religious School. The religious school and teen program fees are separate from a family's membership dues.

    Religious School Fees

    Grade Total School Fee Teen Program Fee
    Pre-K - Kindergarten $480.00 --
    1st Grade $510.00 --
    2nd Grade $537.00 --
    3rd Grade $537.00 --
    4th Grade $828.00 --
    5th Grade $828.00 --
    6th Grade $840.00 --
    7th Grade $810.00 --
    8th-12th Grades -- $120.00

  • Child/Teen 1

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  • Child/Teen 2

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  • Child/Teen 3

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  • Child/Teen 4

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  • Child/Teen 5

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  • Yarzheits/Memorial

  • Beth Shalom Photo Policy

    Beth Shalom uses photographs, slides, videos, and illustrations of its members for many purposes.  They may be used in Beth Shalom newsletters or publications, slide presentations, videos, websites, social media, or other similar forms of communication about the Beth Shalom community.  We will not identify any youth, and we will not include any identifying information such as personal email addresses, phone numbers, home addresses, and date of birth with any photo.

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    2024-2025 Financial Information

  • We hope that each member's affiliation with the Beth Shalom family brings a sense of belongingness, joy, learning, and lasting friendships though community, prayer, study, and social action.  To successfully support our Jewish community and the many families, adults, and youth who rely on us to engage and further their Jewish identity, we rely on members' dues and donations.  To guide families in making their financial contribution, the Beth Shalom Board has developed suggested membership dues for each family.  We understand that this amount may not accurately reflect a family's ability to contribute; some families will be able to contribute less, and some will be able to contribute more.

    Below are the current suggested Membership Dues for each family situation.

    2024-2025 Suggested Membership Dues

    Age of Oldest Adult as of July 1 Individual Family
    Under 30 $84.00 --
    Under 30 $252.00 $504.00
    30-34 $756.00 $1499.00
    35-64 $2066.00 $2640.00
    65 and over $1121.00 $1865.00

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    Honor Circles

  • For those who can contribute more than their suggested membership dues, Beth Shalom has developed Honor Circle donations.  Those whose membership dues and yearly donations total to the following amounts will receive the following incentives.  We also recognize all Honor Circle families at our annual Donor Appreciation Event.

    Honor Circle Annual Dues and Donations Incentives
    Mitzvah Circle $4158.00 Acknowledgement in Annual Report
    President's Honor Circle $6237.00 Mitzvah Circle Plus Two Tickets to all Beth Shalom Events Except the Gala
    Rabbi's Honor Circle $8316.00 President's Honor Circle and a 2025 Reserved High Holy Days Seats in the Sanctuary
    Circle of Blessing $10395.00 Rabbi's Honor Circle and Reserved High HOly Days Upper Parking Spot
    Circle of Life 12474.00 Same as Circle of Blessing and Rserved Upper Level Parking Spot for 2024-2025 Fiscal Year

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    Summary

  • Please type in what you think is a workable amount for your 2024-2025 Membership Dues below.  These dues do not include any religious school or youth program fees.

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    Signature & Submission

  • By typing our name(s) below, I/we are stating that the information in this application is true, I/we agree to the policies outlined, and I/we are applying for membership at Beth Shalom. I/we also understand that Beth Shalom may conduct a background check.

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