FORM Please enable JavaScript in your browser to complete this form.Please turn this form into the synagogue office by June 30, 2020. Your registration will entitle you to receive High Holiday Tickets and religious school admission.Congregant Family:Check here if your contact or family information has changed. Please notify the office using the CBS Family Changes Notification form available from the office and on your website(www.cbs-scv.org).Step 1: Select your annual membership pledge Your membership pledge commitment last fiscal year(not including school fees) was. Would you consider pledging for the upcoming year? The sustaining amount required to fund CBS's activities for the new fiscal year requires an average membership pledge of $1,000.Membership TypeFounder * $7,200 ($600/mo)Benefactor* $4,200 ($350/mo)Mensch* $3,000 ($250/mo)Provider* $2,000 ($167/mo)Supporter* $1,200 ($100/mo)Chai* $600 ($50/mo)Suggest/OtherOther* Eligible for family High Holy Day tickets.Step 2: Total FY 2019 Commitment with Religious School FeesTotal Membership Pledge Commitment Selected from Step 1Total from Religious School Registration Report(currently enrolled students - registration report)Total from New Religious School Enrollment forms (newly enrolled students)Donation to CBS's Scholarship Fund - help fund religious education for deserving childrenTotal FY 2019 Commitment - enter here and in the highlighted space in Step 4Step 3: Register for auxiliaries (with separate checks)Sisterhood (Separate check payable to CBS Sisterhood) | # to Register$Amount | $36.00Men's Club (Separate check payable to CBS Men's Club) | # to Register $Amount | $36.00USY / Kadima (Separate check payable to CBS USY) | # to Register$Amount | $75.00/$70.00/$50.00**YSY: first child at $75 and additional children at $70 each. Kadima: $50 each. Please list children's name below and indicate USY or KadimaMembership related forms are available at https://cbs-scv.org/resources. You may pay your membership pledge and /or access your statement * transactional activity at https://us.rakefetonline.com/#/login. (Contact Robin to assist with credentials if needed).Your current statement as of April 30,2020 is enclosed. Kindly arrange to settle any balances prior to May 31, 2020.Did you know... that CBS's scrip program is easy to use and equally benefits you and CBS? Visit the CBS website, or ask Robin Ceppl!Step 4: Select your Payment Plan - all financial commitments are due in full by May 31, 2021.May check payable to Congregation Beth Shalom for the full selected amount is enclosed.Charge my Visa and MasterCard designated below for the full amount selected.Charge $50 to my credit card shown below now and the balance on December 15, 2020.Design Your Own Contribution Plan (below) - Must be paid in full by May 31, 2021Down Payment $: Bycheckcharge the credit card designated below.Charge the remaining balance of $to my credit card designated below by $per month for (months)Total fiscal year commitment is $ (from Step 2).Credit CardType MC/Visa Card Number:Exp:CVV:Authorizing Signature:Step 5 - Personally Identifiable Information Opt Out Instructions CBS publishes an annual membership roster that includes members' contact information and children's names. All such information will be included in this rosstr unless you provide the Annual Congregational Roster & Opt Out Form(enclosed) no later than November 1, 2020. This form is also available by navigating to the following website link. https://cbs-scv.org/resources/.Please check this box if you elect to provide the Annual Congregational Roster & Opt Our Form available from the office and the CBS website.Step 6 - Sign Your PledgeI/We understand that: Based upon our pledge and the pledges of other congregants, CBS has made commitments to clergy, administrative staff, teachers and others necessary to our synagogue's operations and religious school. I/We have selected the payment plan selected above. My/Our obligations will e current and any special fees paid prior to any simcha (wedding, B'nai Mitzvah, baby naming) provided by CBS. Due to the nature of CBS's voluntary pledge structure the Board of Trustees reserves the right to request or assess further financial support which might include a mandatory assessment from its members in the event of a revenue shortfall. Name & SignatureDateName & SignatureDate MessageSubmit
