2022-23 Membership Commitment

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The Village Temple Membership 2022-2023

CONFIDENTIAL

The Village Temple is a place for kesher - connection. It is a home for contemporary Reform Jews who are seeking connections to Torah and the search for spiritual fulfillment, links between past and present and one generation to the next.

We invite all who wish to join us to enter our doors: Jews by birth, Jews by choice and interfaith families. Inside you will find a community of people who are on a quest to reshape Shabbat and holiday worship, reinvigorate Jewish learning, and renew our commitment to tikkun olam. For further information on Village Temple programs, please contact the office at 212-674-2340 ex 6 or at villagetemple@villagetemple.org.

Membership dues are for the fiscal year starting July 1, 2022 through June 30, 2023

* If any member is experiencing a financial hardship a special arrangement can be made by contacting Sandy Albert, Executive Director, at salbert@villagetemple.org before filling out this form so an arrangement can be made.

Thank you for your support.

Please complete the 2022-23 membership form:

* Membership Status

Section 1 - Membership Dues (required):

Family Membership -- $3055.00Single With Children Membership -- $2110.00Out of Town --$1130.00Single -- $1765.00Young Associate --$755.00New Member with Child entering 1st-2nd Grade - $0

Section 2 - Building Fund Assessment:

$2,000 payable over four years in $500 increments to start in the second year of membership. If you have paid this already in another congregation please let us know!

Section 3 - Security Fee

* Annual Security Fee -- $345.00

Annual Security Fee -- $345.00

Section 4 - Voluntary Contributions: Community Circle $600 or other amount.

Our community circle donation underwrites membership dues for congregants who require assistance

Donation Amount

Section 5

How many adults in your household:

Anniversary:

If applicable.

Adult 1:

* First Name:

* Last Name:

Birthday

Phone Number:

E-mail:

Your confirmation of form submission will be sent to this address.

Mobile Phone :

Occupation :

Employer :

Religion at Birth :

Current Religion :

Adult 2:

* First Name:

* Last Name:

Birthday

Phone Number:

E-mail:

Your confirmation of form submission will be sent to this email.

Mobile Phone :

Occupation :

Employer :

Religion at Birth :

Current Religion :

Children: (under the age of 26 living at home)

# of children:

Child 1:

* First Name:

* Last Name:

* Birthday (MM/DD/YYYY):

Email (if applicable):

Child 2:

* First Name:

* Last Name:

* Birthday (MM/DD/YYYY):

Email (if applicable):

Child 3:

* First Name:

* Last Name:

* Birthday (MM/DD/YYYY):

Email (if applicable):

Child 4:

* First Name:

* Last Name:

* Birthday (MM/DD/YYYY):

Email (if applicable):

Address(es):

* Home Address:

* City:

State:

* Zip

Section 6 - Yizkor Information

The Village Temple uses the secular date of death for Yahrzeit observance. If you prefer the Hebrew date, please let us know.

Name

Relationship

Date of Death

Name

Relationship

Date of Death

Name

Relationship

Date of Death

Photograph/Media Release Form:

During the course of the year, many photographs are taken by our staff and volunteers. Photographs are used in a variety of publications including, but not limited to, newsletters, marketing materials, social media, communications and the website.

Please complete the following information providing consent for use of photographs:

* I give consent to use photographs of my household:

Total Amount Due:

Clicking "Submit" will take you to the payment page where you can choose your payment type (credit card +2.5% fee, e-check no fee, or bill to account for sending alternative payment) as well as select your payment plan.

* Signature:

Please type full name.

Fri, May 10 2024 2 Iyyar 5784