Membership Renewal Welcome! Thank you for renewing your membership with Congregation Bonai Shalom. We’re so grateful to be in community with you. Step 1 of 7 14% Personal InformationName* First Last Has you personal information changed in the past 12 months?*YesNoAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhoneAdditional Phone (optional)New Family Member First Last RelationshipSpouse/PartnerChildSiblingParentGrandparentAunt/UncleCousinBirthdate/Anniversary New Family Member First Last RelationshipSpouse/PartnerChildSiblingParentGrandparentAunt/UncleCousinBirthdate/Anniversary Divorce/Separation(new contact info if needed)New Yahrzeit(Name, date, and before or after sunset) Membership CategoryOur policy is not to deny membership based on financial need. If you would like to be considered for a dues reduction please select your membership category on this page and then during checkout indicate your request for dues adjustment in Step 6.Choose your membership category*Family (2+ people): $2,800.00Individual: $1550.00Senior Couple (67+): $1775.00Senior Individual (67+): $1025.00Young Family (under 30): $1300.00Young Individual (under 30): $730.00Yedid Hakehillah/Conversion Student (under 30): $260.00Teen/College Student: $180.00Associate (member of another congregation): $730.00Friends of Bonai ($180)Please enter the name and city of your primary synagogue:* Building FundWe’ve been working hard to be good stewards of our properties! New members of CBS are assessed a one-time Building Fund fee of $3,300, typically paid over six years at $550 per year. If you have been a member for less than six years your building fund contribution this year is $550. If you have fulfilled your building fund, please enter zero (0) in the box. Building Fund Commitment*This year's building fund contribution ($550)I have fulfilled my building fund and would like to make other donation this year (see below)I have fulfilled my building fund and do not wish to contribute this year ($0)I am requesting dues adjustment (see below)Building Fund Adjusted Payment Starting this year, if you have requested dues adjustments you will automatically be billed $10 per month for your building fund contribution. Please multiply the number of months between now and June 30, 2017 by $10 (example: 8 months x $10= $80) and enter that amount in the box above. Building Fund Other Payment If you have fulfilled your building fund and would like to continue to contribute, please enter this year's amount here. Aliyah Plus Giving CategoryThank you to our Aliyah members. Bonai Shalom has set its dues level at a level that historically supports 50 -60% of our community budget. We rely on contributions and fundraising for the remaining 40-50% we spend on our sacred community. The delicate balance of dues, contributions and fundraising has historically left us in many years with a deficit of 1-7% This year we experienced a deficit that works out to about $250 per membership. Your additional contribution at the Aliyah levels assists us to continue to provide a high level of service to the community and results in a balanced budget. Aliyah Memberships are entitled to extra High Holiday tickets as follows: Mensch - 1 ticket Madrich - 1 ticket Chaver - 1 ticket Tomech - 2 tickets Parnas - 4 tickets Shutaf - 6 tickets Shomer - 6 ticketsAliyah Plus Giving CategoryShomer (Guardian): $7,200Parnas (Benefactor): $5,400Shutaf (Partner): $3,600Tomech (Supporter): $1,800Chaver (Friend): $1,000Madrich (Guide): $500None at this time I/we would like to remain anonymous Sponsoring a Kiddush I/we would like to sponsor a Kiddush Date: I/we would like the Kiddushin honor ofin memory ofNameSponsorship TypeFull: $425.00Please try to find me a co-sponsor: $220.00Kiddush Sharing InformationI am willing to share this day.I do not want to share this day. Dues AdjustmentI/we are requesting a dues adjustmentCheck "Yes" if applicable. YesNoReason for Requesting Dues AdjustmentNo JobMedical BillsFixed IncomeAnnual Household IncomeCongregation Bonai Shalom is a membership organization working within a limited budget to bring you outstanding kiddush, programming, services and learning. Our community works hard to ensure no one is turned away due to financial hardship. When requesting adjustments, we ask that you consider the value of Bonai Shalom in your life as it compares to elective expenses such as cable bills or gym memberships. Please note that Bonai Shalom has set its dues level at a level that supports the community but has historically resulted most years in a deficit. We are limited in the reductions we can provide as the funds come from the contributions of others in our small community. Approximately 30% of our congregation pays adjusted dues and 40% pay adjusted tuition totaling $140,000 or 25% of our budget. We have researched and selected the nationwide reference of the fair share dues model for reductions which is based on Household income. You must have a payment plan in order and have paid 25% of your total dues by September 1, 2016 to be eligible for High Holiday tickets. Enter your annual household income here:Choose your discounted membership categoryFamily (2+ people): $600.00Individual: $300.00Senior Couple (67+): $600.00Senior Individual (67+): $300.00Young Family (under 30): $600.00Young Individual (under 30): $300.00Yedid Hakehillah/Conversion Student (under 30): $260.00Teen/College Student: $180.00Associate (member of another congregation): $730.00Individual ($300)Friends of Bonai ($180)Adjusted Membership Dues Price: $0.00 Payment Schedule & Method SelectionIt is CBS policy that if you are on adjusted dues/tuition you must have monthly payments set up via auto pay by ACH or Credit Card. Please help save CBS money and consider paying your dues by ACH (automatic withdrawal from your bank account)! Note: To be eligible for High Holiday Tickets, at least 25% of your dues and fees and any unpaid prior-year dues and tuition balances must be received (or payment plan in place) by August 1, 2016. Select a Payment Schedule*Annual (full payment)Quarterly PaymentsMonthly PaymentsSelect a Payment Method*Continue to use the method I currently have on fileBy ACHBy Credit CardBy CheckBy Stock TransferIf you continue to charge the card/account we have on file, please select the first choice. If you are changing your payment method please make a new payment choice and contact us at 303-442-6605 or email@example.com.Your Annual PaymentYour Quarterly PaymentYour Monthly PaymentYour Discounted Annual PaymentYour Discounted Quarterly PaymentYour Discounted Monthly PaymentYour Adjusted Yearly PaymentYour Adjusted Quarterly PaymentYour Adjusted Monthly PaymentCommentsThis field is for validation purposes and should be left unchanged.