Young Adult Membership Form

ONLINE YOUNG ADULT MEMBERSHIP APPLICATION

Our Congregation welcomes all members of the Jewish community and their families. As a non-profit organization, Congregation Shir Ha-Ma'alot is supported by the commitment and collective strength of our members. We are honored that you have chosen Shir Ha-Ma'alot (SHM) for your spiritual home.

SHM is pleased to offer special financial commitment membership rates for adults up to age 35. The oldest person in a couple would determine the age level. All benefits of membership are included and can be found on the front cover of the membership application. Young Adult/Family membership is limited to the young adults listed on this membership application form.

Financial Commitment- Young Adult Membership

Ages 18-29:

$230 per year (consists of $210 membership dues + $20 security fee)
- This commitment applies until the oldest person in the couple turns 29 years old. When the individual turns 30, the commitment rates would increase to $500 and follow the Ages 30-35 program below.

Ages 30-35:

$500 (consists of $415 for first year of membership + $85 Security Fee)
$795 (consists of $690 for second year of membership + $105 Security Fee)
$1,580 (consists of $1,380 for third year of membership + $200 Security Fee)
$2,345 (consists of $2,070 for fourth year of membership + $275 Security Fee)
Fifth year of membership: $3,5250 Sustaining Dues Level (consists of $2,850 membership + $375 building maintenance fee + $300 security fee)

Benefits of Membership include over 300 programs and events centered on building a warm and vibrant Jewish community as at SHM and include:

New Member Financial Commitment

* Financial Commitment

Ages 18-29: $230/year until age 30Ages 30-35: $500 for first yearNaSHiM Sisterhood (annually)- $36Brotherhood (annually)- $36Please contact me regarding special consideration for membership dues. We strive to make membership affordable to all.

Please choose which age range/membership level you are starting out with.

Terms of Membership Commitment

I/We accept the many benefits of membership in Congregation Shir Ha-Ma'alot and agree to the following:

1. I/We acknowledge a financial commitment to pay the annual membership dues. The annual fiscal year runs from July 1 through June 30.

2. I/We understand that annual membership will be renewed automatically without further action on my/our part unless I/we give written notice before commencement of the new fiscal year that I/we do not want my/our membership renewed.

* Click here if you agree to the above terms of membership

Click here if you agree to the above terms of membership

* I/We agree to pay:

Please Select OnePlease choose which option you'd likeAnnually (charged on July 1st or when application is completed)Semi-annually (Payment 50% due upon completion, remainder due January 1st)Quarterly (Payment of 25% due upon completion, remainder due on October 1st, January 1st, and April 1st)Monthly (Paid monthly from July 1st through June 1st)Please reach out to me regarding our unique payment scheduling

* Preferred Payment Method

Please Select OnePlease choose payment methodCheckACH (Automatic deduction from checking/savings account)Credit Card- MC, Visa (3% credit card fee applied)Credit Card- AMEX (4% credit card fee applied)

Adult #1

First Name

* Last Name

* Nickname

* Email

* Cell Phone

For example, (949) 857-2226

* Date of Birth

* Mailing Address

* Mailing Address City

* Mailing Address State

Mailing Address Zip Code

Home Phone

Hebrew Name

* Religion

JewishNot Jewish

If you are not Jewish, please specify what religion is practice:

Business Name

Occupation

Work Phone

Work Email

Adult #2

First Name

Last Name

Nickname

Gender

Cell Phone

Date of Birth

Hebrew Name

Religion

JewishNot Jewish

If you are not Jewish, please specify what religion is practiced.

Business Name

Occupation

Work Phone

Work Email

Additional Member Information

* Marital Status

Wedding Anniversary Date (if applicable)

What is the best way to contact you?

EmailCell PhoneHome PhoneWork Phone

Yahrzeit Information (Deceased Family Members)

Please write in the deceased person's name, their relationship to you (or other member on this application), and the anniversary date of their death. If there are more than one person, please do so on multiple lines.

Is there anything special about you or your family that you want SHM office/clergy to be aware of? If so, please explain.

Please list any special interests or skills for each member.

Children

Child #1 First Name

Child #1 Last Name

Child #1 Nickname

Gender

Child #1 Hebrew Name

Date of Birth

Grade as of August 2023

Name of School, District

Child #2 First Name

Child #2 Last Name

Child #2 Nickname

Gender

Child #2 Hebrew Name

Date of Birth

Grade as of August 2023

Name of School, District

Child #3 First Name

Child #3 Last Name

Child #3 Nickname

Gender

Child #3 Hebrew Name

Date of Birth

Grade as of August 2023

Name of School, District

If you need to add additional information on your membership application, please write "YES" below.

Our Director of Membership, Lisa Monette, or a SHM staff member will be reaching out to you shortly to gather financial commitment. We look forward to welcoming you into our SHM Community!

Ralphs Re-enrollment Time!

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