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Membership Form

2018-19 Membership Form

Name:
Date of Birth
Name2:
Date of Birth 2
Children Names & Dates of Birth
Address:
Phone:
-
E-mail:

Family Membership includes 2 High Holiday seats

Enter

Single Membership Includes 1 High Holiday seat

Enter2

Associate Membership (a family or individual who has an existing membership at another shul may purchase holiday tickets at $86)

Enter3

Please specify your requirements for High Holiday Seats for this year:

Number of Men Seats Required
Number of Women's seats required:
Please call me at the following number to discuss my seating needs


Additional High Holiday seats may be purchased at the following rate:

Members $86

Non-Members $136

You can go to the donation payment page today online or Email this form and mail a check or call the office 

Enter Dues
 $ 
Additional Seats
Building Maintenance Fund
 $ 
Total:

Congregation Anshe Sholom

2018-2019 Membership 

Application/Dues

Yahrzeit(Please list name, relationships and dates)

Your info is submitted to the office when you hit submit.  You can call the office at 914-632-9220 to pay by phone or you can go to the payment page to pay online with your credit card or Paypal.  We are happy to receive your check in the mail as well.

THANK YOU

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