2017-2018 New Membership Form

How Much to Contribute?

This form will help you calculate your annual pledge for membership support and fees at the standard contribution levels for each age category and membership type. We rely on every member to contribute as much as you are able. For those who are able to contribute an amount greater than the standard contribution level, your additional support allows Judea Reform to be fully inclusive of all Jews, regardless of financial circumstances.

We also recognize that membership support should never be a burden on any member’s budget or a source of stress, and we encourage members who cannot afford the standard contribution level to write in an amount that represents the financial commitment that you are able to make. Alternatively, you may contact our Executive Director or our Financial Secretary to talk about a membership commitment that works for you.

Payment Schedule

You may pay your pledge according to a schedule that is convenient for you. All membership support must be paid in full by the end of our fiscal year: June 30, 2018.

* Your first name

* Your last name

* Birthday

* By which pronouns would you like to be referred (for example, he, she, they, or ze)?

* By which title would you like to be referred (for example, Mr., Mrs., Ms., Miss, or Dr.)?

* In what religious tradition were you raised, if any?

* With what religious tradition do you now affiliate, if any?

* How did you first hear about Judea Reform?

* What is your primary reason for joining, now?

* Your address

Your address (2nd line)

* City

* State

* Zip code

Home phone (with area code, please)

Work phone (with area code, please)

Cell phone (with area code, please

Email address

* Best ways to reach you

Occupation

* Is there another adult head of household in your family? (partner, spouse, co-parent)

Please Select OneYesNo

If this person is your spouse, please share your wedding date

First name

Last name

Relationship to you

By which pronouns would this person like to be referred (for example, he, she, they, or ze)?

* By which title would this person like to be referred (for example, Mr., Mrs., Miss, Ms., or Dr.)

In what religious tradition was this person raised, if any?

With what religious tradition does this person now affiliate, if any?

Cell phone (with area code, please

Work phone (with area code, please)

Email address

Best ways to reach this person

Occupation

Is there another adult head of household in your family? (partner, spouse, co-parent)

Please Select OneYesNo

First name

Last name

Relationship to you

By which pronouns would this person like to be referred (for example, he, she, they, or ze)?

By which title would this person like to be referred (for example, Ms., Mrs., Mr., Miss, or Dr.)?

In what religious tradition was this person raised, if any?

With what religious tradition does this person now affiliate, if any?

Cell phone (with area code, please

Work phone (with area code, please)

Email address

Best ways to reach this person

Occupation

Are there other addresses you would like us to list for you or your family? (e.g. a summer address, an address if the adult heads of household are living separately part of the time)

* Do you have children (including adult children)

Please Select OneNoYes

CHILDREN

Please tell us about all of your children, even those who are now adults.

First child's first name

First child's middle name

First child's last name

By which pronouns would this like to be referred (for example, he, she, they, or ze)?

First child's birthdate

First child's weekday school

First child's grade level in weekday school

Do you have another child (including adult children)?

Please Select OneNoYes

Second child's first name

Second child's middle name

Second child's last name

By which pronouns would this like to be referred (for example, he, she, they, or ze)?

Second child's birthdate

Second child's weekday school

Second child's grade level in weekday school

Do you have another child (including adult children)?

Please Select OneNoYes

Third child's first name

Third child's middle name

Third child's last name

By which pronouns would this like to be referred (for example, he, she, they, or ze)?

Third child's birthdate

Third child's weekday school

Third child's grade level in weekday school

Do you have another child (including adult children)?

Please Select OneNoYes

Fourth child's first name

Fourth child's middle name

Fourth child's last name

By which pronouns would this like to be referred (for example, he, she, they, or ze)?

Fourth child's birthdate

Fourth child's weekday school

Fourth child's grade level in weekday school

Do you have another child (including adult children)?

Please Select OneNoYes

Fifth child's first name

Fifth child's middle name

Fifth child's last name

By which pronouns would this like to be referred (for example, he, she, they, or ze)?

Fifth child's birthdate

Fifth child's weekday school

Fifth child's grade level in weekday school

Do you have another child (including adult children)?

Please Select OneNoYes

Sixth child's first name

Sixth child's middle name

Sixth child's last name

By which pronouns would this like to be referred (for example, he, she, they, or ze)?

Sixth child's birthdate

Sixth child's weekday school

Sixth child's grade level in weekday school

MEMBERSHIP COMMITMENT

Judea Reform Congregation asks you to give from your heart. It is only with your generosity and help that the congregation can maintain and improve our excellent educational programs, beautiful facilities, and inspiring spiritual leadership. Thank you for supporting your congregation!

MEMBERSHIP SUPPORT

By pledging membership support at the recommended level, you ensure that Judea Reform’s foundational needs are met. You are a partner in preserving the great traditions of Judaism, responding to the current concerns of our community, and planning for a future of sacred engagement for generations to come.

Two-Adult Household	Individual (One-Adult) Household
Older Adult is Age 30 or Younger: Free in First Year	Age 30 or Younger: Free in First Year
Older Adult is Age 31: $1,050 ($87.50/mo)	Age 31: $495 ($41.25/mo)
Older Adult is Age 32: $1,375 ($114.58/mo)	Age 32: $750 ($62.50/mo)
Older Adult is Age 33: $1,635 ($136.25/mo)	Age 33: $930 ($77.50/mo)
Older Adult is Age 34: $1,895 ($157.92/mo)	Age 34: $1,125 ($93.75/mo)
Older Adult is Age 35: $2,155 ($179.59/mo)	Age 35: $1,325 ($110.42/mo)
Older Adult is Age 36 & Older: $2,495 ($207.92/mo)	Age 36 & Older: $1,475 ($122.92/mo)

ALTERNATIVE SUPPORT

Membership support should never be a burden on any member's budget nor a source of stress, and we encourage members who cannot afford the standard contribution level to write in an amount that represents the financial commitment that you are able to make. Alternatively, you may contact our Executive Director or our Financial Secretary to talk about a membership commitment that works for you.

CIRCLES OF HONOR

The Circles of Honor provide much-needed annual support for the congregation and allow Judea Reform to open its doors to all Jews seeking a spiritual, intellectual, and social justice home, so we never have to turn anyone away.

Please consider joining one of our Circles of Honor in the 2017-2018 fiscal year if you're able to support us at this level. Circle of Honor gifts already include any additional required fees (excluding Religious School tuition, if applicable).

Circle of Judea: $3,000—$3,599
Circle of Tzedakah Righteousness: $3,600—$4,999
Circle of Mitzvah Commandment: $5,000—$7,199
Circle of Shalom Peace: $7,200—$9,999
Circle of Chesed Kindness: $10,000+

Please select from one of the options below:

Please Select OneI will pledge Membership Support at the recommended level (or higher but not as high as Circles of Honor)At this time I will pledge an alternative amount.I will pledge at a Circle of Honor level.

MEMBERSHIP SUPPORT

If you would like to contribute more for your membership support -– but not as much as one of our Circles of Honor — please indicate the amount below.

Fair Share increase to your pledge:

Your membership commitment, so far

ALTERNATIVE SUPPORT

If you need to contribute an alternative membership support amount, please indicate your pledge below. Or, you may contact our Executive Director to talk about a membership commitment that works for you.

Jennifer Rudinger
jrudinger@judeareform.org
919-489-7062, ext. 224

Alternative pledge amount

Your membership commitment, so far, (adjusted support)

CIRCLES OF HONOR

We hope you will join one of our Circles of Honor in the 2017-2018 fiscal year if you're able to support us at this level. Remember that Circle of Honor gifts already include any additional required fees (excluding Religious School tuition, if applicable).

Circle of Honor pledge amount

Your membership commitment, so far, (Circle of Honor support)

OTHER REQUIRED FEES

These required fees are added to your Basic Membership Support – unless you are pledging at our Circles of Honor levels. Circles of Honor levels include these required fees. If you pledged at the Circle of Honor level, you may skip down to select whether or not you wish to also add ARZA dues to your pledge.

FACILITY MORTGAGE FEE

Please Select OneHouseholds in which the Oldest Member is 65 or Older ($35)One-Adult Households in which Member is between 30 and 64 ($75)Two-Adult Household in which Oldest Member is between 30 and 64 ($120)Household in which the oldest member is younger than 30 (Fee Waived)

Your membership commitment, so far, including facility mortgage fee

ONEG FEE

Please Select OneIn my household the OLDEST ADULT is younger than 78; I understand that my Oneg Fee is $45.In my household the OLDEST ADULT is 78 or older and I understand that my Oneg Fee is waived.

Your membership commitment, so far, including Oneg Fee

SECURITY FEE

Please Select OneIn my household the OLDEST adult is 30 or older. I understand that my Security Fee is $36.In my household the OLDEST adult is younger than 30; I understand that the Security Fee is waived.

Your membership commitment, so far, including Security Fee

CAPITAL MAINTENANCE FEE

For all households, there is a $300 Capital Maintenance Fee in the second through seventh years of membership.

In this first year of your membership, there is no fee.

The Association of Reform Zionists of America, ARZA, supports the Reform movement in Israel, through advocacy, organizing, education, and travel experiences. If you want to support ARZA, Judea Reform makes it easy to join them when you join us. Membership in ARZA costs $50. Membership in ARZA is optional.

I would like to join ARZA, please include their $50 dues charge in my JRC bill.

Your membership commitment, so far, including ARZA dues

Your total membership commitment for 2017-2018

COMMITMENT TO INCLUSION AT JRC

Judea Reform strives to be an inclusive, diverse, and welcoming community to all. We are committed to supporting special needs families and individuals, older adults, interfaith families, people of color, LGBTQ families and individuals, and others who belong to traditionally underrepresented communities within JRC. Our goal is to make it easier for congregants to more fully participate in the religious, social, and educational life of our synagogue.

The following items address the inclusion of interfaith families, children and adults with special needs, and older adults, corresponding to the three Inclusion Subcommittees currently supported by JRC. A comments box is provided in this form for you to describe your specific inclusion needs, which may go beyond our three current areas of focus. The information you provide in this section will be used to make JRC as inclusive as possible. Alternatively, you may choose to discuss these matters directly with clergy, staff, or with the Inclusion or Membership committee chairs.

A. Interfaith Families

The Interfaith Subcommittee works to ensure that families that include non-Jewish members feel welcome at JRC.

If your family is interfaith, please check here.

B. Children and Adults with Special Needs

The Special Needs Subcommittee works to enhance the comfort and participation in JRC activities of children and adults with special needs, including cognitive, behavioral, neurological, developmental, and medical disabilities.

If your household includes people with any of these special needs, please indicate their age range(s).

Under 1818 and Older

If it is okay for someone from the subcommittee to contact you to discuss participation of your family member(s) with special needs, please check here.

If you would like to talk to Rabbi Bach about your concerns, please check here.

C. Older Adults

The Older Adults Subcommittee works to facilitate participation of older adults in JRC activities.

Please check the categories below, if any, that may limit the participation in JRC of one or more older adults in your household.

Hearing challengesVisual challengesMobility challenges

If an older adult in your household is unable to receive emails and would like phone calls for time-sensitive information, such as a fellow congregant's death, please check here.

Comments related to your specific inclusion needs:

Fri, April 26 2024 18 Nisan 5784