Membership

PERSONAL INFORMATION
Full Name*

First Name Last Name
E-mail*
Cell Number*

Area Code Phone Number
I would like to receive news and updates by email
MEMBERSHIP PERKS

* Seats for Rosh Hashanah and Yom Kippur

* Super Member price for Shabbos Children's Programs

* Special Member pricing for Shul programs and events

* Discounted rate on Shul space rental for your Simcha. Subject to availability.

* Discounted Men's Mikvah Entry
Membership Plans - Please choose your membership option:

$500 Single Membership - Includes 1 seat for Yom Tov $750 Senior Membership (65+) - Includes 2 seats for Yom Tov $950 Family Membership - Includes 2 seats for Yom Tov $750 First Year Family Membership - Includes 2 seats for Yom Tov $1,800 Chai Membership - Includes 4 seats for Yom Tov $10,000 Founding Membership - Includes 4 seats for Yom Tov & a plaque on the wall in the Lobby
Seats for Rosh Hashanah and Yom Kippur must be ordered in advance
Members:

Please reserve for me:
Men's Seats that come with my Membership:
Women's Seats that come with my Membership:
Additional seats for Men-Members: $100 per seat
Additional seats for Women-Members: $100 per seat
Seats for Boys under Bar Mitzvah-Members: $36 per seat
Seats for Girls under Bas Mitzvah-Members: $36 per seat
Non-Members:

Please reserve for me:
Non-Member seats for Men: $250 per seat
Non-Member seats for Women: $250 per seat
Non-Member seats for Boys under Bar Mitzvah $72 for members
Non-Members seats for Girls under Bas Mitzvah $72 for members
Please note any seating requests here. We will do our best to accommodate you.
ADDITIONAL CONTRIBUTIONS
Chai for Life - Optional A contribution of “chai” ($18) or multiples of “chai” per month is a great way to ensure a percentage of your ma'aser goes back to your community, to keep YOUR community thriving. The contribution listed will be charged to your credit card monthly. Your name will be displayed with other Chai Club members.

$18 $36 $54 $72 $90 $108 $126 $144
Building Facility Maintenance and Mortgage Debt - Optional

$1000
Total

$0.00

Yes, I'd like to donate the cost of processing this transaction by adding 3%
Authorized amount to be charged

Full Amount Quarterly 10 Months
Any specific instructions please include here:

Payment

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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PERSONAL INFORMATION

Seats for Rosh Hashanah and Yom Kippur must be ordered in advance

Members:

Non-Members:

ADDITIONAL CONTRIBUTIONS