Membership Application - Temple Anshe Hesed

MEMBER 1 INFORMATION

* Member 1 - Title

* Member 1 - First Name

Member 1 - Middle Name

* Member 1 - Last Name

* Member 1 - Cell Phone

* Member 1 - Email Address

* Member 1 - Date of Birth

* Member 1 - Gender

* Member 1 - Home Address

* Member 1 - Marital Status

Member 1 - Anniversary Date

if applicable

Member 1 - Name of Congregation where most recently affiliated, if applicable

if applicable

* Member 1 - Profession/Occupation

* Member 1 - Employer

* Member 1 - Work Phone

Member 1 - Hebrew Name

(if known & applicable)

Member 1 - Religious Background

Member 1 - Is there anything you would like to inform us about your religious background?

Member 1 - Special Skills / Talents you’d like to share

* Member 1 - Chant Torah / Read Hebrew

* Member 1 - May we call upon you to be a Hebrew Torah reader?

Member 1 - Special accommodations needed

Hearing Assistance DeviceVisual ImpairmentOther

Member 1 - If other, please specify

TEMPLE ANSHE HESED INVOLVEMENT

We are always interested in involving our members in the life and activities of our Congregation. Please indicate any areas of interest to the adults in your household.

Member 1 - Please choose the areas you would like to involved in:

Engagement ( Includes Communication, Tikkun Olam, In-reach & Outreach)Gesher Committee (Provides for Youth and Adult Education)Finance (Oversees financial operations of the Congregation)Governance Committee (Ensures leadership succession/development)House/Physical Plant (Supervises maintenance & security, includes the Cemetery)Membership (Responsible for recruitment, integration, retention of members, includes Caring Committee)Special Events (Promotes sense of community, shared observances and holidays)Worship (Coordinates worship, ritual & observances, includes Music Committee)

Member 1 - What additional information would you like to have about the Committees or Temple offerings?

Member 1 - What additional information would you like to share about your interests, skills, or talents?

ADDITIONAL INFORMATION

* Is there a second adult applying for membership?

MEMBER 2 INFORMATION

* Member 2 - Title

* Member 2 - First Name

* Member 2 - Middle Name

* Member 2 - Last Name

* Member 2 - Cell Phone

* Member 2 - Email Address

* Member 2 - Date of Birth

* Member 2 - Gender

* Member 2 - Marital Status

Member 2 - Anniversary Date

if applicable

Member 2 - Name of Congregation where most recently affiliated, if applicable

if applicable

* Member 2 - Profession/Occupation

* Member 2 - Employer

* Member 2 - Work Phone

* Member 2 - Work Address

Member 2 - Hebrew Name

(if known & applicable)

Member 2 - Religious Background

Member 2 - Is there anything you would like to inform us about your religious background?

Member 2 - Special Skills / Talents you’d like to share

* Member 2 - Chant Torah / Read Hebrew

* Member 2 - May we call upon you to be a Hebrew Torah reader?

Member 2 - Special accommodations needed

Hearing Assistance DeviceVisual ImpairmentOther

Member 2 - If other, please specify

Member 2 - Please choose the areas you would like to involved in:

Member 2 - What additional information would you like to have about the Committees or Temple offerings?

Member 2 - What additional information would you like to share about your interests, skills, or talents?

CHILDREN'S INFORMATION

* How many children live in your household?

CHILD 1 INFORMATION

* Child 1 - Name

Child 1 - Hebrew Name

* Child 1 - Date of Birth

Child 1 - Gender/Preferred Pronoun

* Child 1 - Grade (or College level)

* Child 1 - Name of School

Child 1 - Address if not living

Child 1 - Cell Phone, Email, if applicable

CHILD 2 INFORMATION

* Child 2 - Name

Child 2 - Hebrew Name

* Child 2 - Date of Birth

Child 2 - Gender/Preferred Pronoun

* Child 2 - Grade (or College level)

* Child 2 - Name of School

Child 2 - Address if not living

Child 2 - Cell Phone, Email, if applicable

CHILD 3 INFORMATION

* Child 3 - Name

Child 3 - Hebrew Name

* Child 3 - Date of Birth

Child 3 - Gender/Preferred Pronoun

* Child 3 - Grade (or College level)

* Child 3 - Name of School

Child 3 - Address if not living

Child 3 - Cell Phone, Email, if applicable

CHILD 4 INFORMATION

* Child 4 - Name

Child 4 - Hebrew Name

* Child 4 - Date of Birth

Child 4 - Gender/Preferred Pronoun

* Child 4 - Grade (or College level)

* Child 4 - Name of School

Child 4 - Address if not living

Child 4 - Cell Phone, Email, if applicable

OTHER ADULT INFORMATION

* How many Other Adults live in your household?

* Other Adult 1 - Name

* Other Adult 1 - Date of Birth

* Other Adult 1 - Relationship

* Other Adult 1 - Gender/ Preferred Pronoun

* Other Adult 2 - Name

* Other Adult 2 - Date of Birth

* Other Adult 2 - Relationship

* Other Adult 2 - Gender/ Preferred Pronoun

REMEMBRANCE FUND/PERPETUAL MEMORIAL FUND

At Temple Anshe Hesed, we have a special Remembrance/Perpetual Memorial Fund, which is a memorial to a loved one by inscription of his or her name on the Perpetual Memorial List, with a recital on the anniversary of the death, and a listing in the Yom Kippur Roll of Remembrance.

A contribution of $200 or more to the Fund provides these memorials.

* Please choose to remember your loved one’s Yahrzeit (annual remembrance date of relatives who have passed away) by either the Jewish or English calendar. How many Yahrzeit's would you like to remember?

Name of Deceased

Relationship

Relationship to whom?

Date of Death

Please use:

Name of Deceased

Relationship

Relationship to whom?

Date of Death

Please use:

Name of Deceased

Relationship

Relationship to whom?

Date of Death

Please use:

Name of Deceased

Relationship

Relationship to whom?

Date of Death

Please use:

I would like to make a donation to the Remembrance Fund/Perpetual Memorial in the following amount:

TEMPLE ANSHE HESED FINANCIAL AGREEMENT

The Finance Committee would like to thank you for your interest in membership at Temple Anshe Hesed. We are excited to have you as part of our family and hope you’ll find us welcoming and responsive to your needs.

As the committee in charge of Temple finances, we wanted to make you aware of some financial information that could help you in some of your decisions regarding dues commitments.

Our budget operating expenses of Temple Anshe Hesed averages around $400,000 annually. The budget pays for our Rabbi and staff, maintains our building, and supports services for our congregants, as well as membership to our national organization, the Union for Reform Judaism.

Based on our current size of 150 family units, it costs approximately $2000 per family to operate our Temple. We have been very fortunate to have had generous endowments given by those who came before us. They loved Anshe Hesed and wanted to see it continue to prosper. These endowments cover some of our expenses, but we count on our dues paying members for the balance of our operating expenses.

We understand that every family has unique considerations, so please review the Fair Share program with your family in mind. Also, know that the committee is currently reviewing this dues structure. We never ask for proof of income, but we do ask that you use these guidelines to assist in your decision process.

We want you to be part of our vibrant congregation and find fulfillment in your participation. We hope you will find a second home with us and be part of our family. Anshe Hesed means people of lovingkindness and we hope you will be part of that. Your support is vital to us.

A member of the finance committee will be contacting you in the near future to discuss any questions or concerns. Thank you for your interest in becoming a member of Temple Anshe Hesed.

L’Shalom

Temple Anshe Hesed Finance Committee

To the Board of Directors, I hereby agree to this sacred covenant (Brit) and to be committed members(s) of the Temple Anshe Hesed Congregation. I pledge the following Fair Share Commitment based on the chart above:

To make your financial arrangements please click the submit below below. You will have the opportunity to setup a payment plan on the next page. If you wish to pay by check, pleas click the submit button below and choose "Bill to Account" on the next page. Checks can be mailed to: Temple Anshe Hesed - 5401 Old Zuck Road, Erie, PA 16506

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