On This Date , I/We Hereby Apply for Membership in Peninsula Sinai Congregation

MEMBERSHIP INFORMATION

499 Boothbay, Foster City, CA 94404

650-349-2816

On this Date , I/We hereby apply for membership in Peninsula Sinai Congregation.

Name(s) to use on mailing labels:

Home Street Address: ______

City: State: Zip:

Home Phone: ( )

Membership Information

Adult #1 / Full Name:
Nickname: ______
Email address: ______
Jewish? ☐Yes ☐No (see note below) Gender:______
Hebrew Name: (transliterated, e.g. “Zalman,son of Shmuel & Sarah” or “Sarah, daughter of Jacob & Leah”)
______
Occupation:
Work Phone:( )______Cell Phone: ( ) ______
Birth Date: ______
Marital status (optional): Anniversary DateYear (if applicable):
Adult #2 / Full Name:
Nickname: ______
Email address: ______
Jewish? ☐Yes ☐No (see note below) Gender:______
Hebrew Name: (transliterated, e.g. “Zalman,son of Shmuel & Sarah” or “Sarah, daughter of Jacob & Leah”)
______
Occupation:
Work Phone: ( )______Cell Phone: ( ) ______
Birth Date: ______
Marital status (optional): Anniversary Date & Year (if applicable):

Note: Non-Jewish partners are welcome and encouraged to participate in the life of our community. If you have questions or concerns in this area, please talk with our Rabbi.

Child #1 / First Name: School: Grade:___
Last Name: Birth Date: Gender: ______
Jewish? ☐Yes ☐No Interested in enrolling in PSC Religious School? ☐Yes ☐No
Address, if different from yours:
Phone, if different from yours: ( ) ______Email address: _____
Cell Phone (if applicable): ( ) ______Date of Bar/Bat Mitzvah, if applicable______
If this child is an adult (over 21) and is interested in becoming a Member in his/her own right, check here____
Child #2 / First Name: School: Grade:___
Last Name: Birth Date: Gender: ______Jewish? ☐Yes ☐No Interested in enrolling in PSC Religious School? ☐Yes ☐No
Address, if different from yours:
Phone, if different from yours: ( ) ______Email address: _____
Cell Phone (if applicable): ( ) ______Date of Bar/Bat Mitzvah, if applicable______
If this child is an adult (over 21) and is interested in becoming a Member in his/her own right, check here____
Child #3 / First Name: School: Grade:___
Last Name: Birth Date: Gender: ______
Jewish? ☐Yes ☐No Interested in enrolling in PSC Religious School? ☐Yes ☐No
Address, if different from yours:
Phone, if different from yours: ( ) ______Email address: _____
Cell Phone (if applicable): ( ) ______Date of Bar/Bat Mitzvah, if applicable______If this child is an adult (over 21) and is interested in becoming a Member in his/her own right, check here____
Child #4 / First Name: School: Grade:___
Last Name: Birth Date: Gender: ______Jewish? ☐Yes ☐No Interested in enrolling in PSC Religious School? ☐Yes ☐No
Address, if different from yours:
Phone, if different from yours: ( ) ______Email address: _____
Cell Phone (if applicable): ( ) ______Date of Bar/Bat Mitzvah, if applicable______
If this child is an adult (over 21) and is interested in becoming a Member in his/her own right, check here____

Note: Names, addresses, phone numbers, and children’s names and ages will be included on our community list. If you do not want any of these items to be listed, please let us know.

How did you learn about Peninsula Sinai Congregation?

______

MEMBERSHIP INFORMATION

499 Boothbay, Foster City, CA 94404

650-349-2816

Skills & Experiences (adults and children)

(Name) / (Name) / (Name)
Previous Jewish education
(Hebrew school, day school, high school, college)
Reading Torah / Haftarah *
(Please list portion(s) that you already know)
Artistic skills
(e.g., singing, musical instruments, arts/crafts, etc.)
Special skills
(e.g., graphic design, web design, landscaping, etc.)
Other

*May we contact you to read Torah? ☐Yes ☐No

Synagogue Team Interests

(Please indicate which person is interested in each interest you select):

__ Adult Education / __PS Women
__ BikurCholim(visiting the sick) / __ Religious Practices
__ Building and Grounds / __ Religious School/Youth Education
__ ChesedV’Tzedek (acts of loving kindness) / __ Security
__ Environment / __ Technology
__ Finance / __ Teen Activities
__ Israel / __ Tikkun Olam (Social Action)
__Membership / __ Ways & Means
__ Men’s Club / __ Young Family Programming
__ Outreach

MEMBERSHIP INFORMATION

499 Boothbay, Foster City, CA 94404

650-349-2816

PS Women and Men’s Club

*** Membership in Peninsula Sinai Women (PSW) and the PSC Men’s Club is now included with your PSC membership. You will be automatically enrolled at no additional cost. If you would like more details, please contact the PSC office.

MEMBERSHIP INFORMATION

499 Boothbay, Foster City, CA 94404

650-349-2816

Yahrzeit Information (If you would like to be reminded of the anniversary of the death of a loved one):

Name of deceased / Related to whom? / Relationship / English Date of death / Died before
Sundown? * / Hebrew name (transliterated, e.g. “Shmuel son of Avi and Dinah”)

*Note: The time of death (before or after sundown) is needed to determine the date of death on the Jewish calendar.

There are many ways to honor your loved ones. Are you interested in discussing:

__ Memorial plaque with Yahrzeit light

__ Donation in honor of loved one

__ Donation directed to a loved one’s particular interest (i.e. school, synagogue, adult education, etc.)

__ Naming a part of the synagogue in their honor

__ Other

PSC’s Flexible Financial Commitment:

What You Need to Know to Make Your Pledge

We hope that PSC will be a derech, a pathway for making Judaism and Jewish identity a meaningful and spiritually fulfilling part of people’s lives, celebrating and holding sacred the idea that everyone is on a journey, at their own pace and toward their own destination. And there should be no financial barriers to this kind of journey.

In May 2016, our congregation overwhelmingly voted to adopt our new “flexible commitment model.” We count on our members to support PSC with time, energy and financial commitment.

How it works

You decide on your level of financial support for PSC. The amount isself- determined, and regardless of the amount, membership is not affected. You’re a member if you want to be,regardless of how much you contribute.

This financial commitment replaces membership dues, building fees, educational tuition (yes, that means no religious school tuition) and fees, annual High Holyday pledges, and more (though of course you’re always free to make donations any time you like, perhaps in honor of a special occasion, yahrzeit or “just because”).

We’ve done the math

You’ll see the “sustaining amount”—the average cost per member household of keeping PSC functioning.

Be supportive and generous

We urge you to be as generous as you can, keeping in mind that some of our members don’t have the means to pay the “sustaining” amount, and therefore, we need other members to contribute more.

Next steps

As a new member, please make your commitment now by completing this “Financial Commitment” form, sign it and return it to us. Or if you have questions, you can contact me or the office at any time.

We are thrilled that you have chosen to join our wonderfulPSC community and look forward to getting to know you!

Irene Moff

President

Email:

Financial Commitment Form

for Fiscal Year: June 1, 2017 thru May 31, 2018

As member(s) of Peninsula Sinai Congregation, I/we pledge to contribute the amount indicated below to PSC to support all its programs, services, facilities, clergy and staff for fiscal year June 1, 2017 thru May 31, 2018.

—Please check one of the following boxes—

☐ $______(your choice; fill in the amount you are pledging)

☐ $3,600 (double Chai x 100)

☐ $5,400 (triple Chai x 100)

☐ $2,977 (the “sustaining” amount*)

* The “sustaining” amount is the average amount needed from each of PSC’s current 297 member households to fully pay the budgeted expenses that our congregation approved for fiscal year 2017/18. Please consider paying more than the “sustaining” amount to cover shortages from congregants who don’t have the means to pay this amount.

Please sign and date in order to confirm your membership & commitment!

Signature: ______Date: ______

Printed name: ______

Please tell us when you’ll pay your above pledge amount, and we’ll bill you accordingly. I’ll/we’ll pay:

☐ the entire pledge amount upfront (this really helps our shul!)

☐ 50% this month; 50% in 3 months

☐ equal monthly payments starting this month, through May 2018

What are my payment options? You may pay by:

Check: When you receive your statement(s) in the mail, send a paper check
Credit card: We accept this payment method for your convenience, but please note that PSC is charged a transaction fee (about 3%) for each credit card payment. Please let us know below if you can help us cover this cost.

☐ Yes, I/we would be happy to add an additional 3% to my credit card payment to defray card processing fees

☐ No, just charge exactly the amount I/we pledged

For your convenience, we can charge your credit card according to your designated payment plan. Please include your details below:

Name on Card: / Expiry Date:
Credit Card #: / CVV Code:

Alternatively, you can pay your contribution via our website and click on the link “Flexible Commitment” (under Members’ Area).