Membership Form

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Membership Form

P'nai Or, Long Beach
Membership Application 2011-2012 (July 11-June 12)

We ask that new AND renewing members complete an application each year.
Please print and mail completed application to Our Treasurer at address below.

Adult #1 ___________________________________________________________________

First/Last Name Birth date (mo/day) Hebrew Name

Adult #2 ___________________________________________________________________

First/Last Name Birth date (mo/day) Hebrew Name

Membership Anniversary ________________

(Note: Put an X next to any information above that you DO NOT want listed in the membership directory. We send a membership directory to the members of P'nai Or only)

(    ) Address__________________________________________________________________________

(    ) City/State/Zip_____________________________________________________________________

(   ) Home phone_____________________________ (    ) Cell Phone____________________________

( X ) E-mail (adult #1) ________________________________________________

( X ) E-mail (adult #2) ________________________________________________

(   ) Desired P'nai Or E-mail Address(es): __________________________________________________

(Members receive an e-mail address that forwards to your personal e-mail e.g.: FirstNameLastInitial@pnaior.org, please indicate if you deisre your English or Hebrew First Name)

Member's Children:

~ Under 18 no additional cost
~ Ages 18 to 25 may join as Junior Members (fee applies)

___________________________________________________________
Name (Secular/Hebrew) Birth date (mo/day/yr)

Membership Dues:

Membership forms are due July 1 and full payment is appreciated at that time. However, members may choose to pay in two installments: one half by July 1st and the second by December 31st.

P'nai Or dues are tax deductible to the fullest extent allowed by law. Please consult your tax advisor regarding tax-deductible contributions.

____ Member(s)* : $700 per individual = $_______ dues.

____ Generosity Member(s)**: $1000 per individual = $_______ dues.

____ Junior Member(s): $25 per child ages 18-25 = $_______dues.

____ Associate Member(s)*** : $350 per indv. (w/ High Holy Days Tkts) = $_______dues.

____ Associate Member(s)*** : $250 per indv. (w/out High Holy Days Tkts) = $_______ dues.

*We welcome all to be with us. Members support our community financially, and special arrangements for financial hardship may be made by contacting the current year Mazkir(ah).

**Generosity dues are for those who can support the community at this level

***Associate Members are members who choose to support P'nai Or but have dues obligations at other Synagogues, though all are welcome to be full members at anytime.

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Members may choose to make generosity donations from their heart in addition to paying dues. Below are the funds we have available for donation support:

(     ) Donation $_______ General Fund
(     ) Donation $_______ Cantor's Discretionary Fund (Charitable causes chosen by Cantor)
(     ) Donation $_______ Cantor's Salary Augmentation Fund (Additional pay for Cantor)

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Shabbat Services are held throughout the year with the help and generosity of our members.

In the coming year would you be interested in (please check as appropriate):

(     ) Yes. Sponsoring a Shabbat Service(s) (costs: $50)
     $______ total
(     ) Yes. Hosting a Shabbat or Havadallah service at Grace First Presbyterian Church (bringing the Challah and wine and helping with the set-up)

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TOTAL:   Dues / Donations $________

______ I am paying by check. (Make payable to P'nai Or, Long Beach)
                        Amt. Enclosed $_______
                        (at least 1/2 of total of membership dues)

______ I am paying by credit card or e-check using PayPal.

(You may send payment via Paypal address to Treasurer@PnaiOr.org or visit our website and use the PayPal button on the membership form page, scroll down to end of page)

Adult #1 _____________________________________________________________                          Signature                         Date

Adult #2 _____________________________________________________________
                           Signature                         Date

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We create and sustain our community through the efforts and creativity of our members. Please share with us any talents, skills or interests you may have that might be able to assist us:

_______________________________

______________________________

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MAIL COMPLETED FORM TO:

Harold Pottembaum, Treasurer
Pnai Or - Long Beach
P.O.Box 8114
Long Beach, California 90808

If you have any questions regarding membership
or completing this application, please contact our current Co-Maskirah,
Wendy Ferguson @ WendyF@pnaior.org or call her at (562) 364-5154.

Note: All credit card payments are processed via Paypal,
however you do not need a Paypal account. Please click the Donation Button to make a payment via Paypal.