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Donate
CBS Membership Renewal
Please verify reCaptcha before submitting the form.
*
First Name
Middle Name (Optional)
*
Last Name
*
Email Address
*
Street Address
*
City
*
State
--Select State--
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Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip
*
Primary Phone
Type
Home Phone
Mobile Phone
Business Phone
Alternate Phone
Alternate Phone Type
None
Home Phone
Mobile Phone
Business Phone
Th
e
recommended
Fair Share Commitment f
or this fiscal year
i
s
$1,560.00
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 Recognition
If 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)
0
1
2
3
4
5
6
7
8
9
10
Mandatory Maintenance Fund (x $60.00)
0
1
2
3
4
5
6
7
8
9
10
Mandatory Security Fund (x $240.00)
The two mandatory fees required every year are
$60.00
for the
Building Maintenance Fund
and a
Security Fund
Fee of
$240.00
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
0
1
2
3
4
5
6
7
8
9
10
(x $300.00)
Total Due
CBS thanks you for your generous contribution!
So that
we may
bud
get
our
income
and expense, please
help by
indicat
ing in
the space below
how
and when
you e
x
pect t
o be
making your
fair s
hare pledge pa
yment(s).
*
I expect to pay my Fair Share Pledge as follows:
Please Select One
Monthly Installments
Quarterly Installments
In Two Payments*
Single Payment*
Please select Month(s)
July
August
September
October
November
December
January
February
March
April
May
June
*If you selected either a
single payment
or
two payment plan
, please select what month(s) you will be making your fair share pledge. All others can skip this field.
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 CARD
Please 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 DRAFT
Please 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 f
or outstanding
ba
lances
will
be sent by e
lectronic ma
il.
Please be sure to w
atch f
or these,
as
paper
bills
are
onl
y sent
to those
with no computer
access.
Please Do Not Share My _____ With CBS Committees:
Address
Home Phone
Mobile Phone
Email
From time to time the Sisterhood, Brotherhood
or
various
committees
may request
address
or
phone
number
to
publicize the
ir a
ctivities.
We
do
no
t
share
information
with
entities out
side
of
Congregation Beth Shalom.
Total Due by June 30th of the following year. (Fiscal year is July 1st to July 1st).
*
I AGREE
I AGREE
By 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, 2025 and that all information is true and accurate to the best of your information.
Thu, May 1 2025 3 Iyyar 5785