Membership Form
	Directions
	Donations

Memberhsip Form
and Policy
5770, 2009-2010

Our members contribute each year on a voluntary basis to cover our actual costs. This year, the amount we need to raise comes out to an average of $728 for each adult member. We expect that some members will be able to give more, and some less. A minimum donation of $18 (chai) will signal your membership in the community.

Any contribution toward high holiday attendance may be applied to membership later in the year. All contributions are fully tax deductible.

Please print out this form and mail it, together with your contribution, payable to Shir Hadash, to our treasurer:
	Treasurer Shir Hadash P.O. Box 610431 Newton Highlands, MA 02461
Name 1	____________________________________________________
	Email _____________________________________________
	Mobile ___________________   Work ___________________
Name 2	____________________________________________________
	Email _____________________________________________
	Mobile ___________________   Work ___________________
Home phone	_____________________________________________________
Address	_____________________________________________________ _____________________________________________________ _____________________________________________________
Children (indicate birth dates)	_____________________________________________________ _____________________________________________________ _____________________________________________________
I/We plan to contribute $___________ to Shir Hadash for the fiscal year 2009-10:
(  ) Enclosed is a check for the full amount.
(  ) Enclosed is a check for $_________. The balance will be paid in installments.
(  ) Please apply my 2009 high holiday donation of $_________ to this year's membership.