New Individual Membership

Membership Information

Member Name*

Prefix First Last

Marital Status

Married

Single

Gender

Male

Female

Birth Date*

Religious background*

Jewish

Other

Home Phone

Cell Phone*

Email*

Residence Address*

Street Address City State ZIP Code

Mailing Address (if different from residence)

Street Address City State ZIP Code

Do you agree to have your information published in our Directory?*

Member contact information (name, address, phone number, email) is published in the JCSVV Membership Directory. This information is ONLY distributed to JCSVV members. Please inform the JCSVV Office of any changes to your phone numbers, address or email.

Yes

EMERGENCY NOTIFICATION*

Please provide the following information for our records. You can use the + sign to add a second contact. Two emergency contacts are requested.

Name

Relationship

Home Phone

Cell Phone

Get Involved

Ways to Get Involved

We are an all-volunteer synagogue. Our members facilitate our programs and activities, keep our operations going and make our building available for our current members and for future generations. We hope you are able to select your top three choices for how you wish to get involved with the JCSVV community:

Individual Membership Options

How many payments would you like to make?*

Use the dropdown arrow in box below to make selection.

Annual Individual Membership Levels

By choosing a higher level of dues, The Tzedakah Circles, your membership helps make possible programs that inspire us, teach us, and connect us to each other. Your participation in one of the Tzedakah Circles will provide an extra measure of financial support for the synagogue. Use the dropdown arrow in box below to make selection.

Bi-Annual Individual Membership Levels

Quarterly Individual Membership Levels

Monthly Individual Membership Levels

Additional Annual Donation

Additional Bi-Annual Donation

Additional Quarterly Donation

Additional Monthly Donation

Payment Options

Payment Method*

Indicate your method of payment by checking one of the options below:

Credit card

Check

E-check

QCD - Qualified Charitable Distribution

JCSVV adds a 3% card processing fee to all credit card transactions in order to help defer the cost of the credit card processing fees.

Price: $0.00

Total

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Checks are to be made payable to JCSVV and mailed to: The Jewish Community of Sedona and the Verde Valley, PO Box 13, Sedona, AZ 86339. Please indicate that membership application was submitted online.

Arranged for with your bank, brokerage house or credit union. Please ensure that the check is made out to the JCSVV and “dues payment” is noted on the memo line.

This is an option you may choose for paying your membership dues.

Qualified charitable distributions (QCDs) have been permanently extended. Individuals can donate up to $100,000 per year directly from a traditional or Roth IRA to qualifying charities. This is attractive to some investors because QCDs can be used to satisfy required minimum distributions (RMDs) from an IRA without having the distribution included in their income.

If you are interested in this option, you may consult your personal financial planner.

Signature*

Use your mouse to sign. If you have a touch screen, use your finger or stylus. To delete signature, simply click the small circular icon at corner of box and sign again.

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You will receive an email confirmation upon submission.

Product Name