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2025-2026 New Member Form
Please verify reCaptcha before submitting the form.
Please Select Number of Adults in Your Household
1 Adult
2 Adults
ADULT 1
*
First Name
*
Last Name
*
Email
*
Cell Phone
Birthday
Hebrew Name
Profession
ADULT 2
*
First Name
*
Last Name
*
Email
*
Cell Phone
Birthday
Hebrew Name
Profession
Do you live in the same household as Adult 1?
Yes
No
HOUSEHOLD INFORMATION
*
Street
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
Home Phone
*
Adult 2 Street
*
Adult 2 City
*
Adult 2 State
Wedding Anniversary
In order to continue to provide a wide range of spiritual, intellectual and communal programs, we rely on the generosity of our community. The Board asks for a contribution of 3-5% of the annual income from membes and has set the Annual Membership Commitment as noted below.
FAIR SHARE GUIDELINES
Up to (Gross Annual Amount)
Monthly Commitment
Yearly Commitment
Individual Membership
$164.16
$1,970
Family Membership
$275
$3,300
Affiliate Membership
$67.10
$805
$180,000
$450
$5,400
$240,000
$600
$7,200
$360,000
$900
$10,800
The total annual commitment is due on June 30, 2026.
Special Circumstances
|
We aspire to make Temple membership attainable for all who wish to join. If you are unable to meet our minimum Annual Membership Commitment amount, please contact Executive Director, Cynthia Barzilai, for more information. A variety of membership options and payment plans are available.
2025-2026 Membership Commitment
My Annual Commitment Level:
Please Select
Individual Membership
Family Membership
Affiliate Membership
Fair Share (amount higher than set member rates)
I would like to discuss options with the Executive Director, Cynthia Barzilai
If you would like to pledge more than the set amount for the Individual, Family, and Affiliate rates, please pick "Fair Share" and enter your desired amount. If you would like to discuss lower rates, please choose the option to speak with Cynthia.
Please Enter Your Pledge Amount:
Security
*
Security Fee
Please Select One
I agree to pay the $400 Security Fee
I would like to talk to the Executive Director, Cynthia Barzilai
Total Annual Commitment
You may pay the total amount now or you may also set up automatic monthly payments. Click "Bill to Account" if you want to pay via check or Zelle. For any billing or ShulCloud related questions, please email olivia@bethshirshalom.org.
Mon, June 30 2025 4 Tammuz 5785