Shaarey Zedek Congregation Annual Membership - Form - Shaarey Zedek Synagogue and Yeshiva

Please Note:
This form is for CURRENT MEMBERS who plan to pay with Credit Card ONLY.

PLEASE FILL OUT THE FORM (IN ORDER) SO YOUR INFORMATION IS COLLECTED ACCURATELY. DO NOT SKIP AROUND.

If you wish to pay by Check or Zelle or need financial consideration, please do NOT fill out this form.
Please contact the office at 818-763-0560 option 2 or info@valleyshul.com.

Baruch Hashem we were able to keep the same prices as last year!

All balances from previous years must be paid in full, or a payment plan must be arranged prior to receiving seat assignments for the New Year.

Important note: We will try our best to accommodate your seat preferences.
Questions? Contact Rachel Jaffe at info@valleyshul.com

CONTACT INFORMATION

PRIMARY MEMBER INFORMATION

* First Name

* Last Name

* Cell Phone Number

* Email Address

* Is there an additional Adult Member on your account?

SECONDARY MEMBER INFORMATION

* First Name

* Last Name

Cell Phone Number

Email Address

HOME ADDRESS INFORMATION

* Mailing Street Address

* City

* State

* Zip Code

MEMBERSHIP INFORMATION

Membership Type	Annual Cost
Single Membership (ages 33-64)	$975
Family Membership (ages 33-64)	$1,950
Senior Single Not Yet Retired (ages 65+)	$975
Senior Couple Not Yet Retired (ages 65+)	$1,950
Retired Senior Single (ages 65+)	$875
Retired Senior Couple (ages 65+)	$1,750
Young Single First Year at SZ (thru age 32)	No Cost
Young Couples First Year at SZ (thru age 32)	No Cost
Young Single Second Year at SZ (thru age 32)	$550
Young Couples Second Year at SZ (thru age 32)	$850

PLEASE NOTE that no member will be turned away for financial reasons. For personal financial consideration, please contact the office at (818) 763-0560.

HIGH HOLIDAY SEATING

Please select your membership option above so you can select your High Holiday seats.

Women's Hashkama Minyan for Rosh Hashana ONLY is FULL.

* Will you be using your High Holiday Seats?

HIGH HOLIDAY SEATING - MEMBER 1

* First Name

* Last Name

* Which Services will they be attending?

* Which Section will they be sitting?

HIGH HOLIDAY SEATING - MEMBER 2

* First Name

* Last Name

* Which Services will they be attending?

* Which Section will they be sitting?

ADDITIONAL HIGH HOLIDAY SEATING

Women's Hashkama Minyan for Rosh Hashana ONLY is FULL.

* Will you need extra High Holiday Seats?

* How many extra High Holiday Seats?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 1

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 2

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 3

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 4

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 5

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 6

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 7

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 8

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 9

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 10

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 11

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 12

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 13

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 14

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 15

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 16

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 17

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 18

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 19

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

ADDITIONAL HIGH HOLIDAY SEATING - GUEST 20

* First Name

* Last Name

* Ticket Type for this Guest

* Which Services will they be attending?

* Which Section will they be sitting?

* Which Age Group will they be in?

Please share any additional details below.

TOTAL DUE