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HHD 2024/5785 Registration
Annual YK Appeal 2024/5785
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2024 Annual Affiliation Renewal
Please verify reCaptcha before submitting the form.
Please sign into your Congregant Portal Account before filling out this form
. Your login name is your email we have on file. If you need a new password, please choose "Forgot Password," and create a new one. Once logged in, please click on the link for the renewal form.
If we are setting up
Monthly recurring payments,
choose "Bill to my Account"
on Payment Page. If paying by
check, please also
choose "Bill to Account"
on Payment Page
.
If you choose Pay Now, it will charge your credit card on file in full
.
If you need assistance, please email
Rabbiassist@OurShirShalom.org
. Thank you!
*
First Name
*
Last Name
*
E-Mail Address
Street Address
City
State
--Select State--
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Wyoming
Zip
*
Best phone number to reach you
Has any of your contact information changed?
No
Yes
If you checked yes, please contact the office with any changes.
Our
Annual Community Commitment
is based on the belief that we all share responsibility for the fiscal health of our sacred Congregation Shir Shalom community. We appreciate and rely on the financial commitment of each congregant and ask you to make your
Standard Base Community Commitment
so we can continue to fulfill our mission, serve our congregants, maintain our synagogue home, and involve ourselves in community activities
We ask that congregants determine their level of support using the following considerations:
The Standard
Base Community Commitment
amount is a starting point for all congregants.
Certain
“
Allowances
”
(i.e., reductions) are available for congregants who meet specific criteria (1-Adult household, 1-Adult Senior household age 65+, 2-Adult Senior household both age 65+) and who determine that the standard base rate is too burdensome.
Special Arrangements
- C
ongregants who are unable to fulfill the Standard Base Community Commitment (adjusted for allowances, if applicable) may apply for a confidential special arrangement.
Incremental Community Commitment
-
Congregants with financial capacity to support our sacred community in amounts above the Standard Base Commitment are asked to consider making an incremental commitment. This enables us to equitably fund our annual activities.
We ask you to renew your affiliation and continue your support of our sacred community for 2024.
STANDARD AFFILIATION
:
Base Community Commitment: $3,860
Annual Security Fee: $350
Total: $4,210
*
Allowances from standard base rates
:
2-Adult
Senior
household, both age 65+:
(
- $1,612)
=
$2,248
due plus $350 Security Fee
1-Adult household (there is only 1 adult in household):
(- $1,855)
=
$2,005
due plus $350 Security Fee
1-Adult
Senior
household (only 1 adult in household, age 65+):
(
- $2,664)
=
$1,196
due plus $350 Security Fee
Out-of-Area Affiliation:
(reside a minimum of 100 miles from the synagogue)
Out-of-Area
:
$330
Out-of-Area-Sustaining
:
$900
Those requesting a
Special Arrangement
due to financial constraints should contact David Moss, Chair SA Committee (
ShirShalomSA@gmail.com
).
For congregants with SA's that have been finalized, the adjustment for your SA will be reflected in your online account and you should not fill out this form.
Capital Fund Contribution
:
Congregants in a 2-Adult or 1-Adult household affiliation (
not senior
) are also subject to a capital fund commitment, payable in 5 annual installments of $500 (2-Adult) or $250 (1-Adult)
over the third (3) through seventh (7) years of affiliation. These can be included in monthly payments or as a lump sum payment.
Please have Dave Moss contact me/us.
Please have Dave Moss contact me/us.
Please Select Your Payment Type and Community Commitment Below.
As a reminder, all congregants are encouraged to use the standard $3,860 Community Commitment, plus $350 Security Fee, and an Incremental Community Commitment if possible. Category Allowances and Special Arrangements are available for those that qualify and for whom the Standard Base Rate, with or without allowance, is too burdensome.
A 2.5% discount will be applied to this year's Community Commitment if
paying by Check or Cash.
Note: This discount will be reflected in Total below if select pay by check in drop down selection..
Out-of-Area memberships are excluded from this discount.
Amount Due with 2.5% discount applied for Check/Cash payment:
2-Adult Household/Standard Base affiliation: $3,764 plus $350 Security Fee
2-Adult Household Senior (both age 65+): $2,192 plus $350 Security Fee
1-Adult Household: $1,955 plus $350 Security Fee
1-Adult Household Senior (age 65+): $1,166 plus $350 Security Fee
Security Fee of $350 not subject to discount.
PLEASE NOTE WHEN CHOOSING AN ALLOWANCE
:
--To choose the allowance for
2-Adult Senior household, both congregants must be age 65+.
--To choose the allowance for
1-Adult household there must be only one adult in the household
; and, if applicable, their
unmarried dependent children, under twenty-six (26) years of age.
A second non-Jewish or non-participating adult within the household is a congregant for all purposes and therefore this allowance does not apply.
--
Out-of-Area affiliation requires congregant reside a minimum of
one hundred miles from the synagogue.
Please Select Your Payment Type (Credit card or Check/Cash) Here:
*
PAYMENT TYPE: Please use this drop down to select if Paying by Check or Cash to apply the 2.5% discount for payment by check/cash: (Once you select Payment Type you can select your Community Commitment below)
Please Select One
Paying by Credit/Debit Card, (2.5% Check/Cash Discount DOES NOT apply):
Paying by Check or Cash: Apply 2.5 Percent Discount to Community Commitment
By selecting Paying by Check or Cash, the Total at the bottom of this form WILL reflect the 2.5% discount.
Out-of-Area memberships are excluded
from this discount.
Please select your Community Commitment:
*
2024 COMMUNITY COMMITMENT SELECTION:
Please Select One
2-Adult household / Standard Base Rate for all Congregants
1-Adult household with allowance
2-Adult Senior household (both congregants are age 65+) with allowance
1-Adult Senior household (age 65+) with allowance
Out-of-Area Sustaining: includes HHD Tickets- (Note: select No Security Fee below)
Out-of-Area: (Note: select No Security Fee below)
Please Select Your Community Commitment:
*
2024 COMMUNITY COMMITMENT SELECTION:
Please Select One
2-Adult household / Standard Base Rate for all Congregants
1-Adult household with allowance
2-Adult Senior household (both congregants are age 65+) with allowance
1-Adult Senior household (age 65+) with allowance
Out-of-Area Sustaining: includes HHD Tickets- (Note: select No Security Fee below)
Out-of-Area: (Note: select No Security Fee below)
Please Use Drop Down Box Below to Select Security Fee
*
Annual Security Fee: $350: Please select the first option for Security Fee from dropdown below unless Out-of-Area affiliation applies.
Please Select One
Annual Security Fee: $350
Out of Area Membership: No Annual Security Fee Due
For Out-of-Area Memberships, please Select No Annual Security above.
If no selection is made, form will not submit.
Incremental Community Commitment
Congregants with financial capacity to support our sacred community in amounts above the Standard Base Community Commitment are asked to please consider making an Incremental Community Commitment. This enables us to equitably fund our annual activities.
Suggested categories are:
Kehillah Circle up to $499
Mount Sinai Circle $500-$1000
Masada Circle $1100-$2500
Western Wall Circle $2600-$4000
Tower of David Circle $4100-$7500
Please use box below to record the amount of your Incremental Community Commitment for 2023.
Amount of my/our 2024 Incremental Community Commitment:
Thank you!
Payment Arrangements
Congregation Shir Shalom offers payment arrangements.
Please indicate your payment method further below.
Notes
:
Payment in full is expected by January 15, 2024, unless you are enrolled in our credit/debit card Autopay Program.
A 2.5% discount will be applied to this year's Community Commitment if paying by Check or Cash.
Please make this selection above if applicable.
If paying with securities, email
SHamilton@OurShirShalom.org
for instructions.
If selecting
Autopay Program
,
please ensure you have set up a debit or credit card in your congregant portal under “My Account”, Payment Methods, o
r call the Office with your preferred Credit/Debit Card information.
P
lease indicate your preference for Monthly, Quarterly, or Semi-Annual payments below.
By choosing the AutoPay program, you are authorizing the synagogue to charge this card beginning January 2024. If there is a change to the Credit or Debit card to be used, please call the Office.
*
Please Choose Your Payment Method for Your 2023 Community Commitment:
Please Select One
Payment by Check: (selected 2.5% discount above)
Payment by Cash: (selected 2.5% discount above)
Payment by Credit/Debit Card in Full
Would like Recurring Automatic Credit/Debit Card installment payments using card on file: (select payment frequency below)
Securities
*If paying with a Credit/Debit Card in full today, after clicking "Submit" below, choose "Pay Now."
IF PAYING BY CHECK
OR SETTING UP AUTOMATIC CREDIT CARD PAYMENTS
PLEASE CHOOSE
"
BILL TO MY ACCOUNT" ON PAYMENT PAGE.
YOU MUST BE
LOGGED INTO YOUR ACCOUNT
WHILE FILLING OUT THIS FORM TO "BILL TO MY ACCOUNT."
By choosing PAY NOW on payment page, your credit card on file will be charged.
The 2.5 discount will be added in Total below if you selected Paying by Check or Cash in drop down on top of form.
If choosing AutoPay option with Credit/Debit Card, please select "Payment Frequency" below:
Not Applicable: Paying in full by Check, Cash, Credit/Debit or other
Monthly Recurring Payments
Four Quarterly Recurring Payments
Two Semi-Annual Payments
If selecting the Autopay Program, please be sure you have set up a Debit or Credit Card in your congregant portal under “My Account,” "My Payment Methods". Your selection authorizes us to use this card to make payments for you beginning January 2024,
or
call the office with a preferred credit card.
If choosing to pay on a Recurring Payment Plan, list last four digits of Credit or Debit Card to be used:
Your Community Commitment, Security Fee and Incremental Community Commitment Amount will be added to your Account based on your selections.
Total 2024 Community Commitment and Security plus Incremental Commitment if applicable:
Please review your above selections to confirm this Total Amount reflects your choices before hitting submit below.
If you chose paying by check/cash, the 2.5% adjustment
will be
reflected in this Total. Please choose "Bill to My Account" on payment page if paying by check or choosing recurring credit card option.
If "Bill to Account" is not an option, please login while filling out this form.
Please use the space below for any questions/comments:
Thank you for supporting our sacred community at Congregation Shir Shalom.
IMPORTANT NOTE BEFORE HITTING SUBMIT:
Choosing "PAY NOW" on payment page will charge your credit card on file.
If you are paying by check or setting up automatic payment plan, please hit
"Submit"
to go to
PAYMENT PAGE
and choose
:
BILL TO MY ACCOUNT
.
No need to do anything further online once you select "Bill to Account" on payment page and receive confirmation.
If you need help logging in, please email
Rabbiassist@OurShirShalom.org.
Wed, November 6 2024 5 Cheshvan 5785