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2023/2024 Membership Recommitment Form

With completion of this form, you will indicate your intention to renew your commitment to our Temple family. We invite you to include membership support, security fee, Building Fund and TLC registration on a shared payment plan. WE ARE HERE FOR YOU: If you are experiencing financial challenges, if membership dues are a strain at this time, reach out. Contact Allison Shippy, Director of Member Services, at [email protected]

Dues Payment Schedule (required)

Please enter your 4 digit account number from your statement if you know it.

* Please enter your total amount from your statement to be included in your payment schedule (dues, security fee, building fund). You can add on your TLC registration amount if you have already enrolled for the 2023-24 school year. $

We are pleased to offer you many payment options, including paying in full today, making a partial payment today with a payment plan, or simply indicating your membership recommitment and setting up a future payment schedule.

Choice 1 - I would like to pay my total dues amount in full today online using my credit card or direct withdrawal from my checking account.

Choice 2 - I would like to make two equal payments--one today and one at second payment date typed below.

Choice 2- Second Payment Date

Please let us know when we can expect the second payment (before 4/30/24).

Choice 3 - I would like to make four equal payments--one today and the remaining three in October, January, and April.

Choice 4 - I would like to make equal monthly payments through April.

Choice 5 - Deferred Payment. I would like to recommit today but defer payment.

If "Yes", choose one of the Dues Payment Options below.

Deferred Dues Payment Options - If you have chosen to set up a payment schedule for your entire amount, please complete one of the options below:

Deferred Option 1- I would like to make a single payment at a later date. (please type in date below)

Payment date must be before 4/30/24.

Deferred Option 2 - I would like to make two equal payments at later dates. (please type in both dates below)

1st payment date by 11/30/23 and 2nd payment date by 4/30/24.

Deferred Option 3

I would like to make four equal payments in July, October, January, and April.

Deferred Option 4

I would like to make equal monthly payments July through April

Thank you for being a part of our Temple family! We value your commitment and participation in our congregation. If you would like to discuss your membership, explore new ways to engage at The Temple, or otherwise want to connect, please contact Allison Shippy, Director of Membership Services, at [email protected] or 216-455-1703.

Member #1 Information (required)

* Member #1 First Name

* Member #1 Last Name

Member #1 Hebrew Name (if known)

* Mailing Address

* Member #1 Email

* Member #1 Cell Phone Number

Member #2 (if applicable)

Member #2 First Name

Member #2 Last Name

Member #2 Hebrew Name (if known)

Member #2 Email