Dues Consideration Form

A REQUEST FOR SPECIAL DUES WILL NOT BE CONSIDERED UNLESS ALL INFORMATION AS REQUESTED IS COMPLETED.

APPLICANT, PLEASE NOTE: The information requested below is in no way intended to embarrass the applicant, and it will be treated with the utmost confidence. However, any information which is requested, but is not supplied, will render this application invalid.

SPECIAL DUES GRANTED FOR ONE YEAR ONLY: The objectives of Temple Beth Am are to provide and conduct Jewish religious services and education and to provide for and promote the spiritual, cultural and social welfare of its members, its youth, and the community. These objectives can be attained only through the financial support and volunteer activities of all its members, such as the payment of dues, and the financial, religious, educational and social support of synagogue-related programs.

 

Your Name(Required)
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Spouse's Name (if applicable)
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Please include names and dates.