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2023-2024 New Member Form




1370 Abbott Court
Buffalo Grove IL, 60089
Tel: 847-383-5017
www.bethambg.org


MEMBERSHIP PROFILE DIRECTORY INFORMATION

 
PRIMARY MEMBER PROFILE INFORMATION
 

AREAS OF INTEREST AT CONGREGATION BETH AM


SECONDARY MEMBER INFORMATION
 


AREAS OF INTEREST AT CONGREGATION BETH AM

HOME ADDRESS
 

PERMISSIONS
 

FORMER SYNAGOGUE MEMBERSHIP
 

FAMILY INFORMATION

 
Add Children Information

YAHRZEIT INFORMATION
 

Yahrzeit is a Yiddish word meaning the anniversary of a death. It is the yearly anniversary of a loved one’s death (traditionally the anniversary of the Hebrew date, not the Gregorian date). Please refer to our FAQ sheet for any additional explanation needed.

Add Yahrzeit Information

MEMBERSHIP PLEDGE

 

PLEDGE AMOUNT

Please consider a dues pledge in the suggested amount of 1.5% to 2.5% of your annual income. Only annual income up to a maximum of $300,000 for a one-adult family and $400,000 for a two-adult family should be considered when applying the 1.5% to 2.5% guidelines. Dividend and interest income should be included in annual income. The fiscal year begins July 1, 2023 and ends June 30, 2024.

Here are some examples of how to apply these guidelines:

  • Example one: A member family with $60,000 in annual income would select an amount of their choosing between $900 and $1500.
  • Example two: A member family with $120,000 in annual income would select an amount of their choosing between $1800 and $3000.
  • Example three: A member family with $180,000 in annual income would select an amount of their choosing between $2700 and $4500.

Please contact the office at 847-383-5017 for more information or help.


ADDITIONAL MEMBERSHIP OPPORTUNITIES

 
MEN'S CLUB MEMBERSHIP
 

Membership is $36.00/year

SISTERHOOD MEMBERSHIP
 

Membership levels are based on your donation preference.
$36.00/year
$54.00/year
$72.00/year

ARZA MEMBERSHIP


The Association of Reform Zionists of America is the Israel arm of the Reform Movement, representing our community to the Zionist National Institutions in Israel and around the world.


Membership is $50.00/year per household.  For more information about ARZA: https://arza.org/arza-membership/

PAYMENT OPTIONS

 
PLEASE SELECT YOUR PAYMENT SCHEDULE
 

PLEASE SELECT YOUR METHOD OF PAYMENT
 


ACH withdrawals will have an automatic withdrawal on the 15th day of each month according to the payment schedule selected above. IF PAYING BY ACH, a micro deposit may be used to set up your account. The CBA office may reach out to you to obtain those test amounts for security verification.

Credit Cards will automatically be charged on the 15th day of each month according to the payment schedule selected above. CREDIT CARD PAYMENTS FOR ANNUAL DUES AND SCHOOL TUITION ARE SUBJECT TO A 3% SURCHARGE. THIS SURCHARGE IS CAPPED AT A MAXIMUM OF $20 PER YEAR FOR ANNUAL DUES AND $20 PER YEAR FOR TUITION.


WOULD YOU LIKE TO RECEIVE MONTHLY BILLING STATEMENTS?
 

OPTIONAL ACKNOWLEDGMENT TO THE CONGREGATION
 

At the end of the membership year, Beth Am will publicly acknowledge our member families whose fulfilled dues pledges meet one of the following criteria:

  • Two-adult member families whose fulfilled dues pledge is at least $4990
  • One-adult member families whose fulfilled dues pledge is at least $3150
  • Any member family whose fulfilled dues pledge is at least $2525 if that amount exceeds 2% of its annual income.

MEMBERSHIP & PLEDGE AGREEMENT


I hereby make my annual membership pledge to Congregation Beth Am. Beth Am financial commitments must be current to receive High Holy Day tickets and other temple services. I understand that due to budgetary and planning needs, dues are for the entire year and are not refundable even if I choose to resign mid-year. I will provide written notice to the Beth Am office if I wish to discontinue membership. Verbal notice or voice mail does not constitute an official resignation. If I fail to complete an annual pledge form in future years, but my membership has not been officially discontinued, dues may be continued to be charged in the manner listed above for future years at a rate increased by no more than 10% over the previous year. Permission is granted to send announcements, news, and updates to my email address(s). My signature confirms my agreement to abide by the terms and conditions of Congregation Beth Am membership.

 

Please use mm/dd/yyyy format

Sun, May 19 2024 11 Iyar 5784