2021-22 Membership Application

We are delighted you have chosen to be part of the Congregation Beth Chaim community! We hope that you will find membership an enriching experience and encourage you to explore the diverse opportunities for Jewish expression that Beth Chaim offers.

Please call our office at 609.799.9401 if you have any questions or need assistance in filling out this application. All information in this application will be treated confidentially.

Welcome to Congregation Beth Chaim. Please select the best option.

Membership OnlyMembership and School

How many Adults are part of this Membership or School Application

1 Adult2 Adults

FAMILY INFORMATION

Adult 1 Information

First Name

Middle Name

Last Name

Correspondence Email Address

Street Address

City

State

Zipcode

Birth date

Occupation

Hobbies

Hebrew Name

Father's Hebrew Name

Mother's Hebrew Name

Adult 2 Information

First Name

Middle Name

Last Name

Correspondence Email Address

Date of Birth

Occupation

Hobbies/Interests

Hebrew Name

Father's Hebrew Name

Mother's Hebrew Name

Child 1

First Name

Middle Name

Last Name

Hebrew Name

Is this child 18 years old or over?

YesNo

Date of Birth

Name of School Entering in the Fall

Grade Entering in the Fall

Child 2

First Name

Middle Name

Last Name

Hebrew Name

Is this child 18 years old or over?

YesNo

Date of Birth

Name of School Entering in the Fall

Grade Entering in the Fall

Child 3

Child 3 First Name

Child 3 Middle Name

Child 3 Last Name

Hebrew Name

Is this child 18 years old or over?

YesNo

Date of Birth

Name of School Entering in the Fall

Grade Entering in the Fall

Child 4

First Name

Middle Name

Last Name

Hebrew Name

Is this child 18 years old or over?

YesNo

Date of Birth

Name of School Entering in the Fall

Grade Entering in the Fall

Annual Membership Commitment

Couple/Family $2,345
Single Parent $1,805
Single Individual $1,805
Senior Couple (both over 65 on July 1) $1,725
Senior Individual (over 65 on July 1) $1,125
Young Couple (both under 35 on July 1) $825
Young Individual (under 35 on July 1) $500
Associate Member (residence greater than 100mi from CBC) $510
Shalom Member (oldest child in Bagels & Blocks, Kindergarten or First Grade) Tuition ONLY

Sustaining Membership

Donations to our Sustaining Member Program enable us to welcome all who wish to be a part of Congregation Beth Chaim. The suggested levels of gifts below help us to build a sacred community for all.

This year, thanks to a matching grant from the Sadock Family Foundation, every new pledge or increase from last year will be matched dollar-for-dollar. We ask that you consider giving for the first time this year or increasing your pledge if you are in a position to do so.

Donations of any amount are welcome. Below are suggested levels of giving.

Guardian - $3,600 +
Protector - $1,800 - $3,599
Pillar - $720 - $1,799
Benefactor - $360 - $719
Patron $180 - $359

If you have any questions about Sustaining Membership please contact to office at office@bethchaim.org or Marshall Kizner, Chair of the Sustaining Membership Campaign.

How much do you wish to contribute to Sustaining Membership this year?

Gifts can be divided into as many as 10 monthly installments.

Optional Dues and Fees

Optional Dues

Sisterhood

Men's Club

Beth Chaim Temple Youth (BCTY)

SCHOOL ENROLLMENT INFORMATION

SCHOOL FEES

2021-22 School Tuition and Fees:

Bagels and Blocks (3s to pre-K): $55
Kindergarten and First Grade: $972
Second Grade: $1,028
Third Grade: $1,120
Fourth, Fifth and Sixth Grades: $1,156
Seventh Grade: $1,120
Eighth, Ninth and Tenth Grades: $1,054

Name of Student 1

Name of Student 2

Name of Student 3

Name of Student 4

EDUCATIONAL CONSIDERATIONS

In the text box(es) below, please note if your child(ren) have any special needs or considerations that might affect their learning experience. This information will be held in confidence and shared with teachers on an as-needed basis. If you prefer, please reach out to the Director of Lifelong Education, Anne Berman-Waldorf, RJE to discuss.

Student 1

Student 2

Student 3

Student 4

Who is allowed to pick up your child(ren) from school?

Please enter one or more names of people you authorize to pick up your child(ren) after school.

EMERGENCY CONTACT INFORMATION

Please list two people that we may contact in the event we are unable to reach a parent in an emergency.

Emergency Contact 1
First Name

Emergency Contact 1
Last Name

Emergency Contact 1 Relationship

e.g. grandparent, aunt, family friend, etc.

Emergency Contact 1 Phone

Emergency Contact 2
First Name

Emergency Contact 2
Last Name

Emergency Contact 2 Relationship

e.g. grandparent, aunt, family friend, etc.

Emergency Contact 2 Phone

Subtotal - Tuition and Fees

YARZHEIT INFORMATION

Please only fill in NEW Yahrzeit information in this section. There is no need to include loved ones for which you already receive notice. You may verify existing yarzheit information in the My Account section of the website, which can be found by clicking on your name at the top right of any page on the website. (You will need to be logged in to do this. If you are not logged in, you will see a Login button at the top right of every page.)

If you do not wish to do this online you may contact the temple office to review and update this information.

TOTAL:

Includes membership commitment, optional dues, any donations and school registration fees.

PLANNED GIVING

I would like more information about supporting Congregation Beth Chaim.

Please contact me about multi-year giving.Please contact me about legacy giving.

Comments, Questions or Special Requests:

Comments

ADMINISTRATION

On the next page you will be presented with payment options.

Although support from our members is essential to the operation of temple, we are Kehillah Kedoshah--a sacred community. We want the interactions between our office and our members to be a point of connection, not about collections. As you may be aware, the temple made some changes to how membership commitment payments are accepted. We now ask that every member make payment arrangements up-front so that we can better manage temple resources, and focus more on providing the services, programming and education opportunities that are central to who we are as a community.

Membership Dues and Religious School fees are due and payable on July 1. For your convenience, there are a few options from which you may choose.

Pay in Full by check by July 1.
If you choose to pay by credit card (3% fee). -- You may choose to pay in a single payment, or via 2-10 monthly installments, right on the payment page.
Pay by electronic check (ACH) in one payment or up to 10 monthly installments.
Contact the office to make other payment arrangements or to apply for Financial Assistance. Please note that 25% of the dues commitment must be paid by August 1st in or to get High Holy Day Tickets.

If you are not able to make a payment in full, please consider making recurring electronic payments. There is a 3% fee on all credit card transactions, but there is NO additional fee for ACH payments. If you would like to set up an ACH payment, but have trouble using the new system, please enter your TOTAL from above into this form or call or email Wendy Levenkron, our bookkeeper, to set it up for you. We apologize for the inconvenience, we are working with ShulCloud to address this issue.

IMPORTANT NOTE: If you wish to have your contribution billed to your account and wish to establish a multiple payment arrangement, please select Bill To My Account on the next page, and DO NOT change the payment amount/frequency. You will then need to email bookkeeper@bethchaim.org to make your alternate payment arrangements.

By completing this form, I am affirming that all the information entered here is accurate and up to date, to the best of my knowledge.

Please click the 'Save and Continue' button below.

Adult 1 Information

Adult 2 Information

Child 1

Child 2

Child 3

Child 4

Annual Membership Commitment

Annual Membership Commitment

2021-22 School Tuition and Fees:

Comments, Questions or Special Requests:

329 Village Road East l Princeton Junction, NJ 08550 l Tel: 609-799-9401 l Fax: 609-799-9249

office@bethchaim.org l EIN 23-7129982