Membership Renewal Form -

Your Full Name*
Yes, please renew my annual membership at Am Shalom Congregation. By completing and submitting this form I and my family agree to abide by the Constitution, by-laws and regulations of Am Shalom Congregation as duly enacted now or which may hereafter be in force. I also give permission for photos of myself and/or family to be posted on Am Shalom’s website and other social media.
Basic Membership*
Membership - Choose Single or Family Membership (Single parents are single)
- Single Membership $800 ($66.67 per month)
- Family Membership $1500 ($125 per month)
If NOT volunteering please add $100*
If Not Volunteering please add $100 to your Membership
- Not Volunteering add $100
- Yes I/we will Volunteer at Am Shalom
Free Jewish Heritage School (for ages 4 -13) Quantity
Free Jewish Heritage School. Thanks to some very generous donors, we are able to offer our Jewish Heritage School for free on the condition your child attends at least 70% of the classes (19/27). The $400 per child deposit will be refunded at the end of the school year. (You may choose to donate it to Am Shalom or put it towards next year's dues at that time.)
Price: $ 400.00 CAD
I wish to use last year's $400 per child Heritage School deposit (if applicable, if children have attended more than 70% of their classes) in this way:
Please indicate how you wish to apply the $400 per child deposit made last year
- Towards this year's Heritage School classes
- Towards this year's Membership dues
- As a donation to Am Shalom
Building Fund
Building Fund is a lifetime contribution of $1000 per single (includes single parent) or $1800 per family. Please enter what amount you would like to contribute this year. (Most members do $300-$600 a year). When your contribution is complete you will receive a leaf on our Tree of Life in the synagogue lobby.
- My Building Fund is Paid
- Add the Total Family BF $1800
- Add the Total Single BF $1000
- Add $50 per month = $600
- Add $25 per month = $300
- Add $10 per month = $120
Fair Share amount to add*
This is a share support system for membership contributions. It is based on the concept that all shall give according to the blessing which has been given us. Note: we do not ask for any tax information from you, this is on a self-assessment basis. Please add the amount indicated in the chart below to make total dues about 2% of income.
- Income less than $80,000 add $0
- Income $80,000 - $90,000 pay $100 ($8.33 per month)
- Income $90,001 - 100,000 pay $200 ($16.66 per month)
- Income $100,001 - 110,000 pay $600 ($50 per month)
- 110,001 - $120,000 pay $800 ($66.67 per month)
- 120,001 - 130,000 pay $1000 ($83.33 per month)
- 130,001 - 140,000 pay $1200 ($100 per month)
- 140,001 - 150,000 pay $1400 ($116.67 per month)
- 150,001 - 175,000 pay $1600 ($133.33 per month)
- 175,000 - 200,000 pay $1800 ($150 per month)
- 200,001 + pay $2000 ($166.67 per month)
Would you like to also make a donation to one of our funds at this time? If so please indicate which fund you would like to donate to:
What amount would you like to donate?
Total
$ 0.00 CAD
Monthly or One Time Payment*
Please indicate whether you wish to pay the Total Due all at once or divided into equal monthly payments for the remainder of our fiscal year. (May 1 through April 30). Payments will be charged to your indicated card on the 15th of each month.
If the Am Shalom office already has your credit card information on file OR if you are sending in 12 post dated cheques: please hit SUBMIT now. If not, please enter your credit card information (Number and Expiry Date) here and then hit Submit. Thank you.
Enter Credit Card Number and Expiry Date
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Membership Renewal Form

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