Membership-2 - Congregation Beth HaMidbar

Membership Form

Membership packet

Step 1 of 7

Shalom,
Welcome to Congregation Beth HaMidbar. We look forward to your participation. Our membership dues structure for 2017-2018 is as follows:

   Family ....... $475
   Single........ $350
   Visitor........ $150

As always, our congregation does not want financial difficulty to stand in the way of membership. We will be happy to work out a confidential payment plan or reduction of dues where hardship exists. Financial arrangements remain private with only Sheryl Beals our President, and Arlette Guetta, our Treasurer, privy to the accommodation. Please feel free to email Sheryl at sherylebeals@yahoo.com if you wish to discuss this. We are now able to arrange to have your dues automatically deducted from your bank account. Please email yumasynagogue@gmail.com for more information.
The due date for the 2018-2019 membership dues is Wednesday, September 10, 2018. Please contact Sheryl regarding a prorated amount for the current year.
Checks should be made payable to: Congregation Beth HaMidbar, and mailed to:

   P.O. Box 5634 Yuma, AZ 85366

Payment must be received by September 10, 2018, unless other arrangements have been made. Please complete the information requested on the following forms.

Name
Prefix First Middle Last
Phone (Home)
Phone (Cell)
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
The Congregation’s membership list will be sent to all members and will include the above information. The membership list is NOT to be used for any solicitation purposes. Please note if you wish any information to be excluded from the membership list sent to all members.
Special instructions:

Membership Category*
- Family - $475
- Single - $350
- Winter Visitor - $150
Hidden
StartDate
MM
DD
YYYY
Memorial Book Donation - $
We wish to contribute to the Congregation in memory of our beloved departed, whose names are to be printed in the Memorial Book.
High Holidays - $
Total
$0.00
Please skip the Credit Card section and mail a check. Thank you.
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Please skip the Credit Card section and mail a check. Thank you.

“THE MEMORY OF THE RIGHTEOUS SHALL BE A BLESSING”
The affectionate remembrance of our departed dear ones is one of the fundamental strengths of Judaism. The Congregation Beth HaMidbar annual Memorial Book has become a noble tradition. It pays tribute to the relatives, members, and friends who have been called to their eternal rest. It is issued to all congregants for the Yizkor Service on Yom Kippur when we poignantly remember those who have gone before us. On the Day of Atonement we come into the synagogue to pray for life and health. We set aside this special hour for Yizkor to find new strength in the cherished memories for our dear ones whose influence is still reflected in our daily lives.
This Memorial Book is to be a meaningful memento to everyone. It is a fitting Jewish tradition on this occasion to create a living memorial to those who have past by contributing to the synagogue. There is no standard contribution required for inclusion of the names of your dear ones. Therefore, the amount you give is entirely at your discretion. Your contribution helps further the religious, educational, cultural, and social programs of your synagogue. These programs for young and old are the living memorials with which you honor your beloved deceased.
You will help us greatly by replying as quickly as possible so that the book may be completed on time for Yom Kippur. Please respond by Wednesday, September 20, 2017.
Our best wishes for the coming year. May it be a blessed one for you and your loved ones.
In Memory of:
Name Relationship

(click ⊕ to add more names)

Please complete the following items for all family members
First Name Last Name Birthdate (day and month)

(click ⊕ to add names)

During the past year or two there have been more than a couple of occasions in which members of Congregation Beth HaMidbar have been called upon to intervene, manage, or assist in a life cycle crisis. This is generally and rightfully accepted as a proper function of an organized synagogue. However, those of us who are called upon to act in times of dire need are often in the dark regarding who to call and what to do.
As a service to our members important confidential information is gathered to help assist you and your family in case of an emergency. Obviously, you may choose not to fill out some or all the information requested. If you completed this form last year and there are no changes, you need not fill it out this year. If there are changes please just enter the items that have changed.
Hidden
Date*
MM slash DD slash YYYY
Who shall we call?
Name Phone #

(Click ⊕ to add another person) If you have no one to call in case of emergency, please let us know and we will get back to you.
Who will handle your final arrangements?
Do you have a medical power of attorney?
If yes, whom?
Who is your primary doctor?
Do you have a will or trust?
Have you already made final arrangements?
Do you have an attorney? If yes...
Name Phone # Address
Is there any other information you would like us to know?
Post Custom Field

Name	Relationship

First Name	Last Name	Birthdate (day and month)

Name	Phone #

Name	Phone #	Address