Congregation Kol Ami Membership Application FY 2024-25 - Form

We are delighted you have decided to join our family! We are a progressive Reform Jewish congregation founded in 1992 and affiliated with the Union of Reform Judaism. We are respected for our commitment to social justice while warmly embracing and nurturing the spiritual, educational, and familial needs of our diverse community. We welcome everyone: gay, lesbian, bisexual, transgender, non-binary, and straight people, their loved ones, families, and friends.

To further your full involvement in the life of the congregation, we ask you to complete this application form. The data you share remains completely confidential. This information helps us gather an accurate profile of our membership and thus enables us to more efficiently plan for our present and future programs.

Thank you for joining us! We look forward to welcoming you as a member of Congregation Kol Ami.

PERSONAL INFORMATION

Title

First Name

Middle Initial

Last Name

Home Address:

City

State

Zip

Cell Phone Number

Home Phone Number

Email Address

Date of Birth

Anniversary

Pronouns

EmployedStudentRetired

Occupation

Name of Company

Work Phone Number

Business Address

City

State

ZIP

Last School Attended

Degree

Social Media (optional)

Facebook

Instagram

Twitter

Upload a Photo (for internal use only):

JEWISH/HEBREW BACKGROUND

Previous Synagogue Affiliation

Board MemberCommittee Member

Bar/Bat Mitzvah

NoYes

If yes, date

Synagogue/Location

Confirmed

NoYes

Conversion Date

Jewish Organizational Involvement

Read Hebrew

Speak Hebrew

Chant Hebrew

Hebrew Name

Add Another Member (Domestic Partner/Spouse)

NoYes

Title

First Name

Middle Initial

Last Name

Cell Phone Number

Home Address

City

State

ZIP

Date of Birth

Pronouns

Occupation

Name of Company

Business Address

City

State

ZIP

Work Phone Number

Last School Attended

Date

Degree

Social Media (optional)

Facebook

Instagram

Twitter

Upload a Photo (for internal use only):

JEWISH/HEBREW BACKGROUND

Previous Synagogue Affiliation

Board MemberCommittee Member

Bar/Bat Mitzvah

NoYes

If yes, date

Synagogue/Location

Confirmed

NoYes

Jewish Organizational Involvement

Read Hebrew

Speak Hebrew

Chant Hebrew

Hebrew Name

FAMILY

Children living at home

NoYes

Full Name

Birth Date

School/Grade

Full Name

Birth Date

School/Grade

Full Name

Birth Date

School/Grade

Children out of home:

NoYes

Full Name

Age

Cell Phone Number

Marital Status

Full Name

Age

Cell Phone Number

Marital Status

Full Name

Age

Cell Phone Number

Marital Status

Other adults at home:

NoYes

Full Name

Relationship

Full Name

Relationship

Are there special needs in your family of which we should be aware?

Emergency Contact

Full Name

Relationship

Cell Phone Number

YAHRZEIT INFORMATION

Full Name

Relationship

English Date of Death

After Sundown?

YesNo

Full Name

Relationship

English Date of Death

After Sundown?

YesNo

Full Name

Relationship

English Date of Death

After Sundown?

YesNo

Full Name

Relationship

English Date of Death

After Sundown?

YesNo

CEMETERY INFORMATION

I have made arrangements at a cemetery.

Cemetery Name/Location

I have made other arrangements.

Please describe.

Add cemetery information for domestic partner/spouse.

Not Right NowYes

I have made arrangements at a cemetery.

Cemetery Name/Location

I have made other arrangements.

Please describe.

CONGREGATIONAL INVOLVEMENT

Our covenant of membership includes our members’ involvement in the life and activities of the synagogue. Please check the box beside the activities in which you are interested. Domestic Partners/Spouses may show different areas of interest by checking the second set of boxes provided.

MEMBERSHIP STRUCTURE

DUES AS A SOURCE OF FUNDING

Congregation Kol Ami is a non-profit religious institution belonging to its membership. The primary source of funding for Kol Ami’s programs is derived from the dues contributed by its members. The member leadership conducts the business affairs of the synagogue in consultation with Rabbi Eger and the Executive Director. Through careful planning and review, the costs of operation are held to a minimum and are comparable to similar costs of other congregations in urban areas throughout the country.

STANDARD

Standard membership is $2,054 for an individual and $3,048 for a family. There are also membership rates for individuals and families 30 years old and under (see Membership & Donations section). In addition to membership, there is a $100 per household Security Protection fee and a $225 per household Building Maintenance Fund fee. Membership is for a one-year period, based on the synagogue’s fiscal year which begins July 1 and ends June 30. Membership may be paid annually (July 1), or over 10 months, starting July 1. Payment can be made by credit card (Visa, MasterCard, Discover, AMEX) or by check (see Membership & Donations section). Anyone unable to pay the Standard membership must speak with a member of the Executive Committee to request dues relief.

GIBORIM (HEROES)
Members are asked to contribute the Standard dues and are encouraged to consider joining our enhanced dues program, Giborim. Members of the Giborim program will receive special recognition as well as the gratitude of our entire community. It is in keeping with Jewish tradition that one contributes in accordance with the material blessings they have received.

RABBIS CIRCLE
Our Rabbis Circle is for members able to contribute $7,500 or more a year and they are invited to exclusive events with our Rabbis. It is our greatest hope that all congregants elect to contribute more than the Standard dues, increasing their level of annual support. This generosity directly enables individuals and families with more limited resources to remain an integral part of the Kol Ami community and advance our mission as a progressive Reform congregation that pursues social justice, supports Israel, and provides a diverse Jewish spiritual home.

FINANCIAL ASSISTANCE
Congregation Kol Ami aspires to build a world where all individuals are honored or connected in community. We have a longstanding tradition of making membership possible for all people, regardless of ability to pay, who want to participate in our progressive, Reform congregation rooted in a rich Jewish tradition, with commitment to social justice, Israel and diversity. As a membership organization with dues as our primary source of funding, we ask all members to contribute at a level that is meaningful to them to support the work we do year round. If you are experiencing financial hardship and are interested in membership, please complete the membership application and select the financial assistance option, and someone from our staff will follow up with you.

LEGACY CIRCLE

AN INVITATION FROM KOL AMI’S LEADERSHIP
We have established the Legacy Circle to honor and recognize members and friends who have remembered Kol Ami through their wills and trusts. We invite you to become a member of the Legacy Circle, helping to ensure the future of Congregation Kol Ami for generations to come. Help to secure the continued availability of our warm and nurturing sanctuary of acceptance and our commitments to Israel and the principals of social justice and diversity. The Legacy Circle will ensure that Kol Ami can generate enough income to maintain the synagogue for years to come. It will be one of your finest legacies.

MEMBERS WILL BE RECOGNIZED IN A VARIETY OF WAYS

Invitations to special gatherings, including dinner with clergy
Acknowledgement on the Legacy Circle plaque placed at the entrance to the synagogue
Invitations to estate planning seminars

TYPES OF BEQUESTS INCLUDE

Designating Kol Ami in your will or trust
Creating a charitable gift annuity
Donating your house or other property, continuing to live there, and receiving an immediate tax deduction

“Great is the privilege of the philanthropist, for [they] awaken the good in the Jewish community. In as much as tzedakah is the Tree of Life, it saves us from death.” - Zohar iii, 111a

MEMBERSHIP & DONATIONS

STANDARD DUES

$2,054 Individual$3,048 Family

30-&-UNDER DUES

$180 Individual$360 Family

I am requesting financial assistance

GIBORIM (HEROES) CONTRIBUTION

Enter your GIBORIM amount.

RABBIS CIRCLE

Gold $15,000+Silver $7,500 - $14,999

Enter your RABBIS CIRCLE amount.

SECURITY PROTECTION FEE (per household) - $120

BUILDING MAINTENANCE FUND (per household) - $225

GRAND TOTAL

DONATIONS (please check all in which you want to participate)

Annual Shabbat Sponsor ($590)

In honor/memory of

Individual Shabbat* Sponsor

[$150 each, *date(s) chosen by you]

Date(s)

In honor/memory of

Memorial Plaque(s)

[$750 each (member price)]

Name of Deceased

English Date of Death

After Sundown?

YesNo

GRAND TOTAL

METHOD OF PAYMENT (dues may be paid over a 10-month period by credit card)

Please charge my credit card

Annually (Jul 1)Ten monthly payments (starting Jul 1)

Please consider including convenience fee of 2.75% (0.0275) to help offset the processing costs of your credit card payment.

IncludeDon't Include

Payment Method

I/We would like to pay by credit card.I/We would like to provide a check.

Credit Card Number

Expiration Date

CVV Number

Zip Code

Signature (type your full name)

I/We am/are sending (a) check(s) in the amount of $

Digital Signature (type your full name)

By signing this application, you hereby grant permission to Congregation Kol Ami to use photographs and/or video of you in publications, news releases, online, and in any other communications related to the mission of Congregation Kol Ami.

For questions, please contact Kol Ami's Administrative Office at 323.606.0996