Draft Membership Page for Internal Use Only

Membership Form 2020-2021

  • Full NameNickname if wish to useBirthdate (month/day/year)ReligionHebrew NameCell PhoneEmail 
  • Adult Full NameOccupation/TitleBusiness NameBusiness PhoneBusiness Email 
  • Full NameHebrew NameBirthdate (day/month/year)AgeGradeSchool Name 
    Children who are single and age 25 or younger are included in your membership.
  • Full NameHebrew NameBirthdate (day/month/year)AgeCell PhoneMarried/Single? 
    Children who are married or single over age 25 are not included in your membership.
  • NamesRelationship 
  • NameGregorian Date of DeathCongregant to NotifyRelationship to Congregant 
    I prefer a reminder on the Hebrew date of death.
    Please check your membership type. The membership (fiscal) year is June 1st through May 31st. Membership commitment amounts may be paid annually, semi-annually or quarterly. There is no pro-ration of commitment amounts until after the High Holy Days. Please note that a discount is offered for payment by check, ACH, or stock transfer. No prospective or current member is denied membership because of financial hardship. A request may be made to Temple Shalom’s Executive Director with a confidential “Request for Adjusted Membership Commitment” form. Tickets for the High Holy Days will be issued when at least fifty percent (50%) of the member’s annual membership commitment has been paid, or if the member has established an accepted payment plan.
  • Annual Security & Major Repair Fee

    All member units pay an Annual Security & Major Repair Fee of $270 (check/ACH)/$280 (credit card)
    I agree to pay all annual membership commitments and fees, as well as (if applicable) all fees for Religious School, Hebrew School, Confirmation, Bar/Bat Mitzvah, etc., per the agreed upon schedule.
  • If under 30, I agree to an annual voluntary commitment. Please fill in that amount.
    A building fund pledge of $1,875 is a requirement of membership. This pledge is payable beginning not later than age 35. If requested, arrangements may be made to pay this pledge over a period not to exceed six years from the date of joining. If the member has paid a building fund at another congregation within the past three years, that amount will be credited toward the $1,875. If a former member rejoins, the difference between the building fund amount at the time of affiliation and the $1,875 will be due. I agree to pay the building fund per the following schedule. Start date deferred until June 2021 ARE WE DEFERRING THIS NEXT YEAR?
  • Religious School Attendance Membership ONLY

    Special Membership for Religious School Attendance Only. This option is priced at $750 ????? per family. No other benefits of membership apply, and no other amounts are charged except per child Religious School Registration and School Fees. Please contact Executive Director Steve Lewis at slewis@templeshalomdallas.org for details.