Temple Emanu-El || Annual Membership Commitment

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First Name:
Last Name:
Spouse Name:
Address:
City:
State:
Zip:
Email:
Phone:

My/Our 2023 Annual Financial Commitment is:		$
Annual Security Assessment (not optional) In addition to dues for all members age 40 and older:		$
My/Our Total Commitment:		$

Membership Types:
Please select your membership type from one of the boxes below:

	FAMILY: Household with Two Adults	INDIVIDUAL: One-Adult Household
SECURITY ASSESSMENT	$100	$50

TORAH CIRCLE
Tzedakah	> $18,000	> $9,000
Shalom	$10,000 - $17,999	$5,000 - $8,999
Simcha	$ 7,200 - $ 9,999	$3,600 - $4,999
Kavod	$ 5,400 - $ 7,199	$2,700 - $3,599
Beracha	$ 3,600 - $ 5,399	$2,000 - $2,699
Chai	$ 3,000 - $ 3,599	$1,750 - $1,999
STANDARD
Sustaining Commitment	$2,500	$1250
Out-of-State	$500	$500
Affiliate (Dual Commitment)	$500	$500

ACCOMMODATIONS	< $2,500	< $1,250
No one is denied membership because of financial hardship. A request may be made for commitment accommodations by contacting our Accounting Manager, Danielle Barnett, at danielle@ourtemple.org or (205) 933-8037, ext 244.

UNDER 40 YEARS – refers to the age of oldest person in the household on Dec 31, 2023 SECURITY ASSESSMENT – optional until 40 years of age

39 years	$2,500	$1,250
38 years	$1,500	$720
37 years	$750	$360
36 years & under	$36	$36

To continue, enter this security code in the box below:

Via PayPal
Note: A 3% processing fee will be added to your on-line PayPal payment.

OR

Please select your installment and payment options below

I/We pledge to pay this year’s Annual Commitment / Security Assessment as
follows (please check one):

Monthly - equal monthly payments, on the 15th of the month

One-time payment, specify preferred month for a reminder (by Oct 2023).

My/Our method of payment is (please check one):

Automatic Bank Draft (ACH) - Preferred method of payment.

Name on Account
Address:
City:
State:
Zip:
Routing Number:
Checking Account No.:
By checking this box you are authorizing Temple Emanu-El to perform an Automatic Bank Draft (ACH) as stated above.

Check - Please mail check to address below.

Stock - Contact Danielle Barnett, Accounting Manager, at 205-933-8037 ext. 244 or danielle@ourtemple.org at the time you arrange a stock transfer so that we can help
facilitate your gift.

Credit Card Payments - All credit card payments incur a 3% processing fee.

Credit Card Type: MasterCard VISA American Express Discover
Credit Card No.:
Security Code:
Expiration:
Name on Card:
	(Exactly as it appears on card)
By checking this box you are authorizing Temple Emanu-El to charge your credit card as stated above.

Your banking and credit card information is kept secure using SSL 256-bit encryption.

Send payments to:
Temple Emanu-El 2100 Highland Avenue So. Birmingham, AL 35205
If you have questions, please contact Danielle Barnett, our Accounting Manager, 205-933-8037 ext 244