New 'Chaights' Fundraiser
Purim
Membership
Youth Programs
Donations
Shabbat
STAND
News
Contact
Calendar
New 'Chaights' Fundraiser
Purim
Membership
Youth Programs
Donations
Shabbat
STAND
News
Contact
Calendar
MEMBERSHIP APPLICATION
2023-2024 Fiscal Year Beginning JULY 1st
Name - Member #1
*
Name - Member #1
First Name
Last Name
Date of Birth - Member #1
*
Date of Birth - Member #1
MM
DD
YYYY
Primary Phone - Member #1
*
Primary Phone - Member #1
(###)
###
####
Email Address - Member #1
*
Email Address - Member #1
Name - Member #2
Name - Member #2
First Name
Last Name
Date of Birth - Member #2
Date of Birth - Member #2
MM
DD
YYYY
Primary Phone - Member #2
Primary Phone - Member #2
(###)
###
####
Email - Member #2
Email - Member #2
HOUSEHOLD INFORMATION
Primary Mailing Address
*
Primary Mailing Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Alternate Mailing Address
Alternate Mailing Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
If seasonal, please indicate date range:
Preferred method of communication
*
Email Member #1
Email Member #2
Primary Mailing Address
Alternate Mailing Address
Would you like to be included in the membership directory?
*
Yes
No
OPTIONAL PERSONAL INFORMATION
Anniversary (Month and day)
Mobile Phone - Member #1 (if different from primary phone above)
(###)
###
####
Mobile Phone - Member #2 (if different from primary phone above)
(###)
###
####
Occupation - Member #1
Occupation (optional work contact information):
Occupation - Member #2
Occupation (optional work contact information):
Hebrew Name - Member #1 (including father & mother's hebrew names)
In format _______ben______v'____
Hebrew Name - Member #2 (including father & mother's hebrew names)
In format ____ben____v'____
ADDITIONAL FAMILY INFORMATION
CHILDREN INCLUDED IN FAMILY MEMBERSHIP (include additional names on separate sheet of paper - including if desired of spouses of adult children and any grandchildren you would like us to know about)
Please provide Hebrew names for any minor children
If you would like to receive Yahrzeit reminders, please provide information below:
Names, Hebrew name, date (before/after sundown)
OPPORTUNITY FOR PARTICIPATION
I/We are able to volunteer for:
Publicity
The Har (20s & 30s)
Event support
Fundraising
Other
Please describe if you have any contributions of time you can make to our Mountain Family:
MEMBERSHIP GIVING LEVELS
Please select
Family $750
Couple $750
Individual $375
Buddy's Run $1,500
Heavenly Daze $2,500
See Me $5,000
Storm Peak $7,500
The Chutes $10,000
Why Not $15,000 and above
ADDITIONAL CONTRIBUTIONS
Additional contributions may be added on payment screen for: General Fund, Burt Halberstadt & Susan Handloff Educational Fund, and/or Rabbi's Discretionary Fund
Har Mishpacha means "Mountain Family"
We are committed to a policy of nondiscrimination in our membership and participation so as to involve all individuals and families, regardless of background, financial means, gender, marital status, race, or age, in participating in our congregation. We remain understanding of the needs of those with both traditional and nontraditional Jewish backgrounds. We look forward to welcoming and involving residents of our community as well as guests interested in our congregation.
Please note: No Person or Family will be denied Membership, High Holiday Admission, or Participation in Har Mishpacha programs due to financial hardship. Please contact Steve Bloom at 314-323-7225 if you would like to set up a payment plan, need financial assistance, or have questions about the dues structure.
The Jewish Congregation of Steamboat Springs 'Har Mishpacha' is a 501(c)(3) Colorfado non-profit corporation. Contributions are tax deductible within the limits of the law.
ONCE YOU CLICK THE SUBMIT & CONTRIBUT BUTTON YOU WILL BE DIRECTED TOU OUR SECURE WEBSITE AT SHALOM CLOUD WHERE YOU CAN MAKE YOUR CONTRIBUTIONS
Thank you!
