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New Membership Application 2019-20

IMPORTANT:

Please be sure to enter your information EXACTLY as you want it to appear on your account. Please do not type in all caps and be sure to double check before submission. Thank you in advance!
 
CONTACT INFORMATION

Information for Adult #1

Parent's Information

Yahrzeits Observed

Please note that we have provided room for 3 Yahrzeits on this form. If you require more, you will be able to provide additional information once your form is submitted and your account is active.


Information for Adult #2

Parent's Information

Yahrzeits Observed

Please note that we have provided room for 3 Yahrzeits on this form. If you require more, you will be able to provide additional information once your form is submitted and your account is active.


Children's Information

First Child
 

Second Child
 

Third Child
 

Membership Commitment & Enrollment Information

Suggested contribution levels are based around a "Sustaining Level," which is the average amount needed from each member household to sustain the operations, facilities, programs, and services at Adat Ari El.  This excludes Adat Ari El schools, which will continue to remain funded primarily though tuition. The endowment remains independent.

Suggested Contribution Levels:

  • Contributing: $500 - $1,799
  • Supporting: $1,800 - $2,799
  • Sustaining: $2,800 - $3,599
  • Cornerstone: $3,600 - $5,399
  • Pillar: $5,400 - $7,199
  • Benefactor: $7,200 - $9,999
  • Guardian: $10,000 or more

Recognition on the Annual Giving Wall is offered to those who contribute at or above the Sustaining Level.

Your contribution of $500 or more includes High Holy Day tickets for 4 members of your household. Additional High Holy Day tickets are available as follows:

  • Under 5 - FREE
  • Ages 6 - 26 – $18 
  • Ages 27-29 - $75
  • Ages 30 and up - $100

Giving levels have been provided below. Please enter the exact amount you wish to pledge for membership in the space provided below each giving level. This section is required. If you do not enter an amount here, your membership form is not complete and we will follow up with you.
"Other" is any amount under $500, it cannot be 0.
Payment Method Selection
If you opt to pay in installments, please note the maximum installment number is 10. 

High Holy Day Tickets and Information

Please select the number of High Holy Day tickets you will require. (If you pledged $500 and up and need more than the 4 tickets you are entitled to, you may purchase additional tickets by selecting the below.) Additional High Holy Day tickets will not be disbursed until their payment is completed in full. 
 
   Ages 6 - 26 - $18/ticket
   Ages 27 - 29 - $75/ticket
   Ages 30 and up - $100/ticket

Total Membership and High Holy Day Ticket Amount:

Subscriptions/Interests


Please let us know if you are interested in starting or joining a program not already listed (for instance: mahjong, book club, hiking group, etc.) We will take your considerations into account when planning programming if we have enough interest.

Check all that apply.

Chavurot
Please separate names with a comma

Adat Ari El Security Information

Emergency Contact Information

Primary Emergency Contact

Secondary Emergency Contact

Vehicle Information

Please note that you will only receive a vehicle sticker in the mail if you fill out information for each vehicle. We require license plate information. Additional vehicle sticker requests may be submitted to the office and we encourage you to call for assistance if you require additional stickers.

First Vehicle

Second Vehicle

Third Vehicle


In applying for Adat Ari El membership, I agree to conform to the By-Laws and to honor all monetary pledges to the congregation. (If you would like a copy of the By-Laws sent to you via e-mail, please contact the office.)

Please sign electronically below:

I/We understand that all resignations from Adat Ari El MUST be received in writing by the administrative office no later than 30 days prior to the effective resignation date. 

Please sign electronically below:

Mon, August 19 2019 18 Av 5779