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Membership Form 2024-2025 New Members
Please verify reCaptcha before submitting the form.
We are excited to welcome you to the Temple Sinai community!
PLEASE BE SURE TO SELECT YOUR MEMBERSHIP TIER AND CHOOSE EITHER A SINGLE OR FAMILY MEMBERSHIP (where applicable) BEFORE SUBMITTING THE FORM.
Please note: required fields are marked with an asterisk.
Adult 1
(Account Primary)
*
Title
Mr.
Mrs.
Ms.
Mx.
Dr.
*
First Name
*
Last Name
Nickname/Preferred Name
Gender
Preferred Pronouns
Please select one
he/him/his
she/her/hers
they/them/theirs
ze/hir/hirs
no pronouns - please use my first name
not listed
If your preferred pronouns aren't listed, please specify
*
Marital Status
Please select one
Single
Engaged
Married
Divorced
Separated
Widowed
Partnered
*
Birthdate
Anniversary
Contact Information
*
Email
*
Cell Phone
Background Information
*
Religious Upbringing
Please select all that apply
Reform
Conservative
Reconstructionist
Orthodox
Secular
Non-Jewish
If you converted to Judaism, when and where did you convert?
Hebrew Name (please write in English)
Hebrew Name (in Hebrew)
Education
College Attended
Degree
Year Graduated
Do you have additional degrees you would like to include? Please use the dropdown below to select the number of degrees you would like to add.
0
1
2
3
4
5
6
7
8
9
10
College Attended
Degree
Year Graduated
Employment Information
Occupation
Company Name
My company matches donations
My company matches donations
Is there a second adult in your household?
Please select one
Yes
No
Adult 2
(Account Secondary)
Title
Mr.
Mrs.
Ms.
Mx.
Dr.
First Name
Last Name
Nickname/Preferred Name
Gender
Preferred Pronouns
Please select one
he/him/his
she/her/hers
they/them/theirs
ze/hir/hirs
no pronouns - please use my first name
not listed
If your preferred pronouns aren't listed, please specify
Marital Status
Please select one
Single
Engaged
Married
Divorced
Separated
Widowed
Partnered
Birthday
Anniversary
Contact Information
Email
Cell Phone
Background Information
Religious Upbringing
Please select all that apply
Reform
Conservative
Reconstructionist
Orthodox
Secular
Non-Jewish
If you converted to Judaism, when and where did you convert?
Hebrew Name (please write in English)
Hebrew Name (in Hebrew)
Education
College Attended
Degree
Year Graduated
Do you have additional degrees you would like to include? Please use the dropdown below to select the number of degrees you would like to add.
0
1
2
3
4
5
6
7
8
9
10
College Attended
Degree
Year Graduated
Employment Information
Occupation
Company Name
My company matches donations
My company matches donations
*
Home Mailing Address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip
Home Phone
Do you have a second home where you spend considerable time (3 months or more)
Please select one
Yes
No
*
Second Home Address
*
Second Home City
*
Second Home State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Second Home Zip Code
Second Home Phone
Do you have children residing in your home?
Please select one
Yes
No
Children
(who live with you)
*Please provide us with your child(ren)'s cell phone (if applicable), so our clergy can be in touch with them when necessary.
Please use the dropdown to select the number of children who live with you.
0
1
2
3
4
5
6
7
8
Child's First Name
Child's Last Name
Gender
Birthdate (MM/DD/YYYY)
School Attending in 2023/24
Grade (if applicable)
Cell Phone
Do you have adult children who do not live in your home?
Please select one
Yes
No
Adult Children
(who don't live with you)
Please use the dropdown to select the number of adult children who don't live with you.
0
1
2
3
4
5
6
7
8
Child's First Name
Child Last Name
Gender
Birthdate (MM/DD/YYYY)
Married or Partnered?
Yes
No
Full Name of Spouse/Partner (if applicatble)
Special Accommodations
Do you have any family member who needs assistance to participate in temple life?
Please select one
Yes
No
Please specify (eg Visual impairment, Auditory impairment, Physical challenges, etc
We want to get to know you better! We invite you to share your hobbies, interests, and passions with us so we can make your temple experience even better!
Check all that apply for Adult 1 (account primary)
Advocacy/Social Justice
Art/Museum Visits
Baking
Board Games/Card Games
Camping
Choir/Singing
Clergy Classes/Torah Study
Cooking
Crafts
Cycling (indoor or outdoor)
Dancing/Israeli Dancing
Diversity/Equality/Inclusion
Event/Party Planning
Exercise/Working Out
Films/Movies
Forming Friendships
Fundraising/Development
Genealogy
Hiking/Climbing
Check all that apply for Adult 1 (account primary)
Knitting/Crocheting
Mah Jongg
Music/Concerts
Nature/Outdoors
Painting
Parenting Workshops
Photography/Videography
Politics
Sewing/Needlepoint/Quilting
Skiing
Social Action
Social Media
Sports
Theatre
Travel
Woodworking
World Jewry
Worship
Writing/Editing
Yoga
Have an interest you'd like to add for Adult 1? Let us know below!
Check all that apply for Adult 2 (account secondary)
Advocacy/Social Justice
Art/Museum Visits
Baking
Board Games/Card Games
Camping
Choir/Singing
Clergy Classes/Torah Study
Cooking
Crafts
Cycling (indoor or outdoor)
Dancing/Israeli Dancing
Diversity/Equality/Inclusion
Event/Party Planning
Exercise/Working Out
Films/Movies
Forming Friendships
Fundraising/Development
Genealogy
Hiking/Climbing
Check all that apply for Adult 2 (account secondary)
Knitting/Crocheting
Mah Jongg
Music/Concerts
Nature/Outdoors
Painting
Parenting Workshops
Photography/Videography
Politics
Sewing/Needlepoint/Quilting
Skiing
Social Action
Social Media
Sports
Theatre
Travel
Woodworking
World Jewry
Worship
Writing/Editing
Yoga
Have an interest you'd like to add for Adult 2? Let us know below!
We know your inbox is probably overflowing with emails, so we want to send you temple emails that are relevant to you. Please indicate which categories are of interest to you.
PLEASE NOTE:
At least one adult in your household
MUST
be subscribed to our Emergency and Important Information email list. Please indicate below which email address(es) should be subscribed to this list.
*
Subscribe this email address to the Emergency & Important Information email list
Subscribe this email address to the Emergency & Important Information email list
*
Check all that apply for Adult 1 (account primary)
Adult Learning and Engagment
Advocacy
Art/Museum Visits
Baking/Cooking/Food
Brotherhood/Men's Programs
Clergy Classes/Torah Study
Early Childhood
Films/Movies
Friend of a Friend/Women's Programs
Guest Speakers
Holiday Celebrations
Israel
Life Cycles
Music/Concerts
Networking/CONNECT
Parenting Workshops
Religious School
Social Action
Social Justice
Special Events
Teen & Youth Engagement
Travel
Weekly Events and Programs ("the Sunday email")
World Jewry
Worship
Check all that apply for Adult 2 (account secondary)
Adult Learning and Engagment
Advocacy
Art/Museum Visits
Baking/Cooking/Food
Brotherhood/Men's Programs
Clergy Classes/Torah Study
Early Childhood
Films/Movies
Friend of a Friend/Women's Programs
Guest Speakers
Holiday Celebrations
Israel
Life Cycles
Music/Concerts
Networking/CONNECT
Parenting Workshops
Religious School
Social Action
Social Justice
Special Events
Teen & Youth Engagement
Travel
Weekly Events and Programs ("the Sunday email")
World Jewry
Worship
Membership is a relationship - a loving commitment with the Jewish people and a statement of mutual support. Membership fees and contributions provide the financial foundation for all that Temple Sinai stands for and strives for. About 50% of our operating budget is funded by membership dues. Dues amounts are proposed by the Board and voted on by the congregation.
Payments may be made:
• annually (single payment)
• semi-annually
• quarterly
• monthly (10 payments July-April)
Members are required to contribute $1800 toward the Building Fund. This fee is payable in installments over the first six years of membership ($300/year) or it can be paid in full. If you contributed towards the Building Fund at another synagogue, kindly furnish proof in the form of a letter from the synagogue, and we will waive the requirement.
Early Childhood Center, Religious School and Teen Programs require a separate application and payment.
Your membership contribution is
TAX DEDUCTIBLE
and
NON-REFUNDABLE
.
We are driven by the principle that
anyone who wants to be part of our community can join, regardless of personal financial circumstances
. Membership should be accessible and irresistible. If you cannot afford to pay the full dues amount, we will meet you at a level you can afford. The Dues Consideration process is simple and confidential; you only need to submit the paperwork once a year.
Our membership tiers provide you with a more personalized experience within our vibrant Jewish community, dedicated to social action,
Torah
learning, and meaningful relationships. Your continued commitment to Temple Sinai of Roslyn opens doors for you and your family to enjoy exciting events as part of a warm, inspiring, and welcoming community.
The actual cost of maintaining Temple Sinai's operations is approximately $6,000 per household. Committing at the
LEV
Champion tier enables us to cover the cost of your membership and ensures TSR's future.
Security assessments are included in all membership tiers.
ADVOCATE
Devotees of Temple Sinai who have children enrolled in Religious School,
B'nei Mitzvah
, or Teen Programs, from Kindergarten through 12th Grade. This is the minimum level of commitment required, as the cost of these programs are partially subsidized by Temple Sinai.
This tier was previously known as the Family Level.
PLEASE NOTE: Tuition for the Early Childhood Center, Religious School, and Teen Programs is ADDITIONAL and requires separate applications.
SUSTAINER
Our basic membership for devotees of Temple Sinai.
Those who join at the SUSTAINER tier may upgrade their tier upon request.
SUPPORTER
The tier for those who belong to another synagogue or live beyond commuting distance (60-mile radius) to Temple Sinai. but wish to remain connected to our community.
GUARDIAN
A reduced-rate membership for devotees of Temple Sinai whose years of temple membership (as the primary or secondary member), PLUS their age equals 100 or more.
PILLAR
Devotees of Temple Sinai
whose years of temple membership (as the primary or secondary member), PLUS their age equals 100 or more, and who choose to make a single, one-time payment that qualifies them as Lifetime Members.
LEV
CHAMPION
Devotees of Temple Sinai, whose dues cover the ACTUAL cost of their household's engagement in the Temple Sinai community.
LEV
BENEFACTOR
Devotee of Temple Sinai whose dues cover the cost of their household's engagement at Temple Sinai AND enables another household to remain as part of our community.
LEV
VISIONARY
Devotees of Temple Sinai whose contribution secures a meaningful center of Jewish life for future generations.
*
Choose your membership tier
Please select one
Advocate
Sustainer
Supporter
Guardian
Pillar
LEV Champion
LEV Benefactor
LEV Visionary
ADVOCATE TIER
* Family $3,300 ($3,200 pay-in-full discount - cash, check, ACH or e-Check only)
* Single $2,100 ($2,000 pay-in-full discount - cash, check, ACH or e-Check only)
ADVOCATE TIER
benefits include:
All worship
including
• High Holy Day tickets for all members of your household, including children 30 years old and younger
• Connection with the clergy (counseling)
• Adult Engagement programming
Life Cycles and Milestones
• Plaque dedications
• Baby naming (during
Shabbat
services)
• Pre-wedding blessing (during
Shabbat
services)
* Funerals
•
Shiva
Minyan
• Unveilings
• Weddings
• Other off-site events
I am joining as a
Please select one
Family
Single
SUSTAINER TIER
* Family $2,100 ($2,000 pay-in-full discount - cash, check, ACH or e-Check only)
* Single $1,300 ($1,200 pay-in-full discount - cash, check, ACH or e-Check only)
SUSTAINER TIER
benefits include:
All worship
including
• High Holy Day tickets for all members of your household, including children 30 years old and younger
• Connection with the clergy (counseling)
• Adult Engagement programming
Life Cycles and Milestones
(onsite only)
• Plaque dedications
• Baby naming (during
Shabbat
services)*
• Pre-wedding blessing (during
Shabbat
services)*
*If held offsite, fees may apply
I am joining as a
Please select one
Family
Single
SUPPORTER TIER
* Family $2,100 ($2,000 pay-in-full discount - cash, check, ACH or e-Check only)
* Single $1,300 ($1,200 pay-in-full discount - cash, check, ACH or e-Check only)
SUPPORTER TIER
includes all the SUSTAINER tier benefits:
All worship
including
• High Holy Day tickets for all members of your household, including children 30 years old and younger
• Connection with the clergy (counseling)
• Adult Engagement programming
Life Cycles and Milestones
(onsite only)
• Plaque dedications
• Baby naming (during
Shabbat
services)*
• Pre-wedding blessing (during
Shabbat
services)*
*If held offsite, fees may apply
I am joining as a
Please select one
Family
Single
GUARDIAN TIER
* Family $2,100 ($2,000 pay-in-full discount - cash, check, ACH or e-Check only)
* Single $1,300 ($1,200 pay-in-full discount - cash, check, ACH or e-Check only)
GUARDIAN TIER
includes all the ADVOCATE tier benefits:
All worship
including
• High Holy Day tickets for all members of your household, including children 30 years old and younger
• Connection with the clergy (counseling)
• Adult Engagement programming
Life Cycles and Milestones
• Plaque dedications
• Baby naming (during
Shabbat
services)
• Pre-wedding blessing (during
Shabbat
services)
* Funerals
•
Shiva
Minyan
• Unveilings
• Weddings
• Other off-site events
I am joining as a
Please select one
Family
Single
PILLAR TIER
A one-time payment of $36,000 - member for life.
PILLAR TIER
includes all the ADVOCATE tier benefits:
All worship
including
• High Holy Day tickets for all members of your household, including children 30 years old and younger
• Connection with the clergy (counseling)
• Adult Engagement programming
Life Cycles and Milestones
• Plaque dedications
• Baby naming (during
Shabbat
services)
• Pre-wedding blessing (during
Shabbat
services)
* Funerals
•
Shiva
Minyan
• Unveilings
• Weddings
• Other off-site events
LEV
CHAMPION TIER
$6,000
LEV
CHAMPION TIER
includes all the ADVOCATE tier benefits:
All worship
including
• High Holy Day tickets for all members of your household, including children 30 years old and younger
• Connection with the clergy (counseling)
• Adult Engagement programming
Life Cycles and Milestones
• Plaque dedications
• Baby naming (during
Shabbat
services)
• Pre-wedding blessing (during
Shabbat
services)
* Funerals
•
Shiva
Minyan
• Unveilings
• Weddings
• Other off-site events
PLUS:
• Donor acknowledgements
• Two tickets to the Annual Gala
• Two High Holy Day Guest Tickets
• Membership in both Brotherhood and Friend of a Friend
• ARZA and Joy of Shabbat donations
LEV
BENEFACTOR TIER
$10,000
LEV
BENEFACTOR TIER
includes all the
LEV
CHAMPION tier benefits:
All worship
including
• High Holy Day tickets for all members of your household, including children 30 years old and younger
• Connection with the clergy (counseling)
• Adult Engagement programming
Life Cycles and Milestones
• Plaque dedications
• Baby naming (during
Shabbat
services)
• Pre-wedding blessing (during
Shabbat
services)
* Funerals
•
Shiva
Minyan
• Unveilings
• Weddings
• Other off-site events
• Donor acknowledgements
• Two tickets to the Annual Gala
• Four High Holy Day Guest Tickets
• Membership in both Brotherhood and Friend of a Friend
• ARZA and Joy of Shabbat donations
PLUS
• Gala Sponsorship valued at $500
• High Holy Days parking spot
•
Mezuzah
and clergy blessing
LEV
VISIONARY TIER
.
$18,000
LEV
VISIONARY TIER
includes all the
LEV
BENEFACTOR tier benefits:
All worship
including
• High Holy Day tickets for all members of your household, including children 30 years old and younger
• Connection with the clergy (counseling)
• Adult Engagement programming
Life Cycles and Milestones
• Plaque dedications
• Baby naming (during
Shabbat
services)
• Pre-wedding blessing (during
Shabbat
services)
* Funerals
•
Shiva
Minyan
• Unveilings
• Weddings
• Other off-site events
• Donor acknowledgements
• Two tickets to the Annual Gala
• Four High Holy Day Guest Tickets
• Membership in both Brotherhood and Friend of a Friend
• ARZA and Joy of Shabbat donations
• Gala Sponsorship valued at $500
• High Holy Days parking spot
•
Mezuzah
and clergy blessing
PLUS
•
Kol Nidre
contribution of $3,000
• Gala contribution of $3,000
• Feature article about your household in the SCRIBE
Sun, September 8 2024 5 Elul 5784