CBS Membership Renewal - Form - Congregation Beth Shalom

* First Name

Middle Name (Optional)

* Last Name

* Email Address

* Street Address

* City

* State

* Zip

* Primary Phone

Type

Alternate Phone

Alternate Phone Type

The recommended Fair Share Commitment for this fiscal year is $1,550.00 per Family.

* My Fair Share Commitment This Year

Please enter the total amount of Fair Share you can afford this year.

In addition to my Fair Share, I Pledge an Additional:

Suggestions:
Platinum Donor: $2,300+*
Gold Donor: $2,200.00*
Silver Donor: $2,000.00*
Benefactor: $1,800.00*
*Includes Recognition in the HaShomer

Don't Include HaShomer Recognition

Don't Include HaShomer RecognitionIf you pledged an additional amount but DO NOT want to be recognized in the HaShomer, please check this box. We thank you for your additional pledge!

* Mandatory Fee Schedule for Membership (must select 1 each)

Mandatory Maintenance Fund (x $80.00)

Mandatory Security Fund (x $100.00)The two mandatory fees required every year are $80.00 for the Building Maintenance Fund and a Security Fund Fee of $100.00 per family. Please select a minimum of 1 for each, or if you are able to give additional to either support a needy member family who may not be able to pay or you would like to generously offer additional please increase your quantity.

I would Like to Reinstate My Building Pledge Fund for Additional Years

(x $300.00)

Total Due

CBS thanks you for your generous contribution!

So that we may budget our income and expense, please help by indicating in the space below how and when you expect to be making your fair share pledge payment(s).

* I expect to pay my Fair Share Pledge as follows:

PAYMENT PREFERENCE
Please note, this is just a generalization for our records and your selection can be changed later by contacting the office at any time or you can split payments across all payment methods.

I PREFER TO PAY BY CREDIT CARD

I PREFER TO PAY BY CREDIT CARDPlease check this box if you will be paying by credit/debit card. You will be provided with a secure payment form link after submission of this form or you may contact the office to setup the payment portion.

I PREFER TO PAY BY CASH, CHECK, OR BANK DRAFT

I PREFER TO PAY BY CASH, CHECK, OR BANK DRAFTPlease check this box if you prefer to pay by cash, check, or bank draft and will be submitting, mailing, or dropping off your payment.

Statements for outstanding balances will be sent by electronic mail. Please be sure to watch for these, as paper bills are only sent to those with no computer access.

Please Do Not Share My _____ With CBS Committees:

AddressHome PhoneMobile PhoneEmailFrom time to time the Sisterhood, Brotherhood or various committees may request address or phone number to publicize their activities. We do not share information with entities outside of Congregation Beth Shalom.

Total Due by June 30th of the following year. (Fiscal year is July 1st to July 1st).

* I AGREE

I AGREEBy checking this box and submitting this form, you agree to pay the total amount due for the upcoming CBS fiscal year membership renewal. You also understand that payments must by made in full by no later than June 30th, 2021 and that all information is true and accurate to the best of your information.