Membership 2022-2023 - Hebrew Tabernacle Congregation

Hebrew Tabernacle Membership 2022/23

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Thank you for your interest in joining Hebrew Tabernacle!

Please use this form to start a new membership or renew your current membership as well as register your children for Hebrew School. We can’t wait to welcome you into the HT family (again or for the first time)! Please do not hesitate to reach out with questions, thoughts, or concerns. We look forward to gathering, sharing, learning, celebrating, and worshipping together in person in the year ahead.

Will you be joining as a 1 or 2 adult household?(Required)

Adult #1(Required)

First Last

Adult #1 Email

Adult #2(Required)

First Last

Adult #2 Email

If you are a returning Hebrew Tabernacle member or family and all of your contact information is the same as last year, you do not need to provide those details again.(Required)

Returning HT member(s) and contact information has not changed.

New member(s) or contact information has changed.

Adult #1 Cell Phone(Required)

Adult #1 Home Phone

Adult #1 Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Adult #2 Cell Phone

Adult #2 Home Phone

Address is the same as member one.

Yes

Adult #2 Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

The Hebrew Tabernacle Membership Directory is a wonderful resource for Hebrew Tabernacle Families. May we include your contact information in this year's directory? If so, please indicate what information you would like included. Multiple boxes may be checked.(Required)

Name(s)

Address

Phone number(s)

E-mail(s)

Child(ren)'s Name(s)

No, Please do not include any information in the Membership Directory

Do you have children under the age of 18?(Required)

Yes AND they will be enrolling in Hebrew School!

Yes but they will not be enrolling at this time.

Do you have children under the age of 5?(Required)

Yes, and I am interested in a full membership for my family.

Yes, and I am only interested in a Tot Membership for my child.

Names and Ages of your children (if you'd like us to know)

Are you registering children who have already participated in our Hebrew School?(Required)

Yes, and none of their personal information has changed.

Yes, but I need to update some of their personal information.

No, this is the first time attending Hebrew School for one or more of my children.

Child's Name (Additional children may be added below.)(Required)

First Last

Date of Birth

MM slash DD slash YYYY

Preferred Pronouns

Student's Day School & Grade

Student's Cell Phone (if applicable)

Needs and Accommodations (please check all that apply):

Student has an IEP or 504 plan

Student has dietary restrictions

Student takes medication

Student has other special needs

Needs and Accommodations Description

Provide information below about medication, dietary restrictions, allergies and other information that will help us best accommodate your child's needs. If you have a copy of the student's IEP and 504, please provide it. All information will be kept confidential.

Hebrew Class Child #1 is Entering(Required)

Aleph ($250)

Bet ($500)

Gimmel ($500)

Dalet ($500)

Hay ($500)

Vav ($500)

Zayin ($500)

Hebrew High ($500)

I'm not sure (We'll be in touch to let you know!)

I would like to enroll a 2nd child in Hebrew School.(Required)

Yes

No, but I have another child whose information I would like you to know.

Child #2's Name(Required)

First Last

Child #2's Date of Birth

MM slash DD slash YYYY

Student #2's Date of Birth

MM slash DD slash YYYY

Preferred Pronouns

Student #2's Day School & Grade

Student #2's Cell Phone (if applicable)

Student #2's Needs and Accommodations (please check all that apply):

Student has an IEP or 504 plan

Student has dietary restrictions

Student takes medication

Student has other special needs

Student #2's Needs and Accommodations Description

Hebrew Class Student #2 is Entering(Required)

Aleph ($250)

Bet ($500)

Gimmel ($500)

Dalet ($500)

Hay ($500)

Vav ($500)

Zayin ($500)

Hebrew High ($500)

I'm not sure

I would like to enroll a 3rd child.(Required)

Yes

No, but I have another child whose information I would like you to know.

Child #3's Name(Required)

First Last

Child #3's Date of Birth

MM slash DD slash YYYY

Student #3's Date of Birth

MM slash DD slash YYYY

Preferred Pronouns

Student #3's Day School & Grade

Student #3's Cell Phone (if applicable)

Student #3's Needs and Accommodations (please check all that apply):

Student has an IEP or 504 plan

Student has dietary restrictions

Student takes medication

Student has other special needs

Student #3's Needs and Accommodations Description

Hebrew Class Student #3 is Entering(Required)

Aleph ($250)

Bet ($500)

Gimmel ($500)

Dalet ($500)

Hay ($500)

Vav ($500)

Zayin ($500)

Hebrew High ($500)

I'm not sure

I need to update my child(ren)'s emergency contacts, authorized individuals, or photo consent.(Required)

Yes

Emergency Contact (Name, Phone, Relationship)

We will always attempt to reach the parent(s) before calling the emergency contact.

Please list all individuals authourized to pick up and drop off your child(ren).

Name

Phone

Click the + sign on the right to add others. Member parents are automatically authorized, no need to include them!

Self Dismiss?

Student #1 is allowed to self-dismiss

Self Dismiss?

Student #2 is allowed to self-dismiss

Self Dismiss?

Student #3 is allowed to self-dismiss

Photo/Video Consent

As the Parent/Guardian of the above student(s), check below to give Hebrew Tabernacle permission to use and/or take photographs and/or videos my child(ren) for use in print or electronic media for the promotion of programs connected with the Hebrew Tabernacle and its Hebrew School.

I give permission

I DO NOT give permission

I give permission for some but not others. (Our Hebrew School administrator will reach out to discuss further.)

We are delighted that your child(ren) will be joining us for Hebrew School! Your total for Tuition has been computed below. Please select your family's membership contribution on the next page.

Senior or College Membership?(Required)

Hebrew Tabernacle offers a discounted membership rate to our valued Seniors, 65 and older, as well as college students. Please let us know if you would like to take advantage of these discounted memberships.

Yes, I would like a Senior Membership.

No, I have not yet reached that level of wisdom and would like an Adult Membership.

No, I'm 65 or older but choose not to take advantage of the Senior discount.

I am a college student.

Senior Membership?(Required)

Hebrew Tabernacle offers a discounted membership rate to our valued Seniors, 65 and older. Please let us know if you would like to take advantage of this discounted membership.

Yes, we would like a Senior Membership.

No, we have not yet reached that level of wisdom and would like an Adult Membership.

No, we are both 65 or older but choose not to take advantage of the Senior discount.

Yes, one of us is 65 or older but the other is not.

Senior Membership Rates(Required)

It is your membership that makes everything that Hebrew Tabernacle provides for the Washington Heights community possible! While our budget has been substantially impacted by the pandemic as well as our A/C renovation, we are committed to keeping entry-level membership affordable to everyone. Of course, for those who have the means, the higher levels of membership offered below play a vital role in meeting our financial needs. At the same time, we know some have been financially affected over the last few years, and we will not allow money to be an obstacle to membership.

Donor Membership ($1,600)

Supporter Membership ($1,200)

Basic Membership ($1,000)

Discounted Membership ($800)

I am a new member and would like to take advantage of the 36% discount ($640)

This is more than I can afford. Please be in touch with me about dues relief.

Senior Couple Membership Rates(Required)

Donor Membership ($3,500)

Supporter Membership ($2,500)

Basic Membership ($2,000)

Discounted Membership ($1,500)

We are new members and would like to take advantage of the 36% discount ($1,280)

This is more than we can afford. Please be in touch with us about dues relief.

One Senior/One Adult Membership Rates(Required)

Donor Membership ($3,600)

Supporter Membership ($2,700)

Basic Membership ($2,250)

Discounted Membership ($1,800)

We are new members and would like to take advantage of the 36% discount ($1,440)

This is more than we can afford. Please be in touch with us about dues relief.

Individual Membership Rates(Required)

Donor Membership ($2,000)

Supporter Membership ($1,500)

Basic Membership ($1,250)

Discounted Membership ($1,000)

Hebrew High School Membership for children, ages 13-18, who are joining alone ($800)

I am a new member and would like to take advantage of the additional 36% discount ($800)

This is more than I can afford. Please be in touch with me about dues relief.

Couple Membership Rates(Required)

Donor Membeship ($3,800)

Supporter Membership ($2,800)

Basic Membership ($2,300)

Discounted Membership ($1,800)

We are new members and would like to take advantage of the 36% discount ($1,472)

This is more than we can afford. Please be in touch with us about dues relief.

Couples With Children Membership Rates(Required)

Donor Membership ($4,000)

Supporter Membership ($3,000)

Basic Membership ($2,500)

Discounted Membership ($2,000)

We are new members and would like to take advantage of the 36% discount ($1,600)

This is more than we can afford. Please be in touch with us about dues relief.

Individuals With Children Membership Rates(Required)

Donor Membership ($3,500)

Supporter Membership ($2,500)

Basic Membership ($2,000)

Discounted Membership ($1,500)

I am a new member and would like to take advantage of the 36% discount ($1,280)

This is more than I can afford. Please be in touch with me about dues relief.

Tot Membership Rates(Required)

Donor ($500)

Supporter ($400)

Basic ($300)

College Student Membership Rates(Required)

Donor ($400)

Supporter ($300)

Basic ($200)

Individuals With Hebrew School Children Membership Rates(Required)

Donor Membership ($3,500)

Supporter Membership ($2,500)

Basic Membership ($2,000)

Discounted Membership ($1,500)

We are new members and would like to take advantage of the 36% discount ($1,280)

This is more than I can afford. Please be in touch with me about dues relief.

Couples With Hebrew School Children Membership Rates(Required)

Donor Membership ($4,000)

Supporter Membership ($3,000)

Basic Membership ($2,500)

Discounted Membership ($2,000)

We are new members and would like to take advantage of the 36% discount ($1,600)

This is more than we can afford. Please be in touch with us about dues relief.

Total

Would you like to make an additional donation towards dues relief for a member in need?(Required)

No additional donation

$180

$360

$720

$1440

Other

Please specify the amount you would like to contribute:(Required)

Would you like to make an additional donation towards a Hebrew School tuition discount for a family in need?(Required)

No additional donation

$90

$180

$360

$720

Other

Please specify the amount you would like to donate:(Required)

Your Total

Total

HUZZAH!! We are almost there. This is your total amount due. Please choose how you would like to send your payment to Hebrew Tabernacle.

I will pay through ZELLE using Hebrew Tabernacle's profile name, bookkeeper@hebrewtabernacle.org.

I will mail or drop off a check to the Hebrew Tabernacle office at 551 Fort Washington Avenue, New York, NY 10033.

I will use PayPal to pay via the Hebrew Tabernacle website after submitting this form.

I would like to set up a payment plan.

Will you add 3% to cover the PayPal transaction fee?

Yes

Transaction Fee:

Price: $0.00

Total

Please identify a payment plan that works for you.

I will pay 50% now, and the other 50% on January 1st.

I will pay 25% now, and 25% on October 1st, January 1st & April 1st.

I would like to speak to someone about an alternative payment plan.

Please tell us a little bit about your circumstances and give us an idea of what you think you can afford.

After you press submit, someone from the office or the Membership Committee will be in touch with you about dues relief as soon as possible.

Minus Amount to be paid later:

Price: $0.00

Minus Amount to be paid later:

Price: $0.00

Equals Amount to be paid now:

First Installment Payment Due Now:

Please choose how you would like to send your payment to Hebrew Tabernacle.

I will pay through ZELLE using Hebrew Tabernacle's profile name, bookkeeper@hebrewtabernacle.org.

I will mail or drop off a check to the Hebrew Tabernacle office at 551 Fort Washington Avenue, New York, NY 10033.

I will use PayPal to pay via the Hebrew Tabernacle website after submitting this form.

Will you add 3% to cover the PayPal transaction fee?

Yes

Transaction Fee:

Price: $0.00

Total