Shalom Aleichem is a member & recipient of funds from the Jewish Federation of Howard County

Family Name: ______________________________ Telephone: ____________________

E-mail: ___________________________________ Fax: _________________________

Address:________________________________________________________________

 

               _______________________________________________________________

Please include my contact information in the temple directory _____YES   _____NO

Given Names of family members (adults first)	Birthdays (M/D/Y)		Given Names of family members (adults first)	Birthdays (M/D/Y)
1.			4.
2.			5.
3.			6.

A member driven congregation requires member participation. Your help is needed. Please indicate committees you would be willing to serve on. (Religious, Education, Membership/PR, Sisterhood)

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SUNDAY SCHOOL REGISTRATION:

Child’s Name ________________________________ Grade in September __________

Child’s Name ________________________________ Grade in September __________

Child’s Name ________________________________ Grade in September __________

Child’s Name ________________________________ Grade in September __________

Please Complete Applicable Categories Below
Please consider paying as much as you can afford

CONGREGATION DUES:				SUNDAY SCHOOL TUITION: (Includes books and supplies)
Family	$795-$975			Each Member Student	$590
Single Parent Family	$580-$670			Confirmations 18-1hr Classes	$200
Couple	$630-$720
Single	$420-$480
Young Adult (18-22)	$50

High Holidays Prayer Book purchase is required. We expect members to have their own books.
Total number of High Holy Prayer Books requested _______ @ $28 each.

If you wish the temple to send you a yahrzeit reminder, please list names below: 

Name _______________________________________Date _____________________

Name _______________________________________Date _____________________

Comments/suggestions additional information can be written on the back of the form.