2023/24 Membership

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Temple Akiba 2023/2024 Membership

Thank you for your interest in becoming a member of Temple Akiba.

If you have a Temple Akiba ShulCloud account please login using the login link in the top right corner of this page prior to filling out this form. If you are unsure if you have an account please email admin@templeakiba.net for assistance.

Form Options: Paper membership forms are also available if the online form does not meet your needs. Please contact our office at admin@templeakiba.net or 310-398-5783.

Payment: You may pay your membership dues by check, credit card, or ACH.

Religious School Enrollment: The Religious School enrollment form will be emailed to you upon completion of the Membership Renewal form. It will also be available in the "My Account" section of your ShulCloud account.

Financial Assistance: At Temple Akiba you will never be turned away because membership dues fall outside your household budget. If you would like to apply for Financial Assistance, please select "Yes" on the "I need to apply for financial assistance" question at the bottom of this form and fill out the requested information.

* I have read and I understand all of the above. I want to proceed using the New Member form.

Household Information

* How many adults are there in the Membership Household?

* Adult 1 First Name

* Adult 1 Last Name

* Adult 1 Preferred Name

Adult 1 Hebrew Name

* Adult 1 Email

* Adult 1 Cell Phone

* Adult 1 Occupation

Please enter even if retired.

Adult 1 Employer

* Adult 1 Religious background in which you were raised

* Adult 1 Religious Background Other

Please list background in which you were raised.

Adult 1 Date of Conversion (if Applicable)

* Adult 2 First Name

* Adult 2 Last Name

* Adult 2 Preferred Name

Adult 2 Hebrew Name

* Adult 2 Email

* Adult 2 Cell Phone

* Adult 2 Occupation

Please enter even if retired.

Adult 2 Employer

* Adult 2 Religious background in which you were raised

* Adult 2 Religious Background Other

Please list background in which you were raised.

Adult 2 Date of Conversion (if Applicable)

* Adult 1 Birthday

* Adult 2 Birthday

* Address

Address Line 2

* City

* State

* Zip

Home Phone

If you do not have a home phone number, please leave this blank.

* Marital Status

Anniversary Date

Please leave blank if you do not have an anniversary date

* Most Recent or Current Congregational Affiliation/Year

* How did you hear about Temple Akiba?

Please list any relatives and friends who are current members of Temple Akiba

Interests and Involvement

We look forward to your participation in a variety of Temple Akiba’s programs and activities, and we encourage you to volunteer your time and expertise to help build our community. Please check the box corresponding to the types of opportunities you are interested in so that we can follow-up with additional information.

Temple Akiba Programs and Activities

Temple Akiba Volunteer Opportunities

Adult 1 Volunteer Opportunities

Caring Community - Outreach to members in need of supportGreen Team – Contribute to a sustainable future at Temple AkibaHigh Holy Days - Greeters and ushers for Rosh Hashanah and Yom Kippur servicesLeadership Development – Explore future leadership roles within Temple AkibaRoom Parent/Helper - Assist your child’s Religious School or ECC classSpecial Events - Help plan the Purim Carnival, Mishloach Manot, Gala and other major eventsTikkun Olam (Repairing the World) - Social action programs including Mitzvah DayTemple Office (Temple mailings / answer phones)

Adult 2 Volunteer Opportunities

Temple Akiba Volunteer Committees

Adult 1 Volunteer Committees

Camps and Youth Programs Committee – Help position Temple Akiba’s youth and camp programs as leading programs in the communityFacilities / Security Committee – Help support the Temple’s physical infrastructureFinance Committee – Help ensure Temple Akiba’s financial futureMembership Committee – Help grow and retain Temple Akiba’s vibrant membership

Adult 2 Volunteer Committees

* Does Adult 1 have professional skills or talents to share with the community? (i.e. Art, music, legal, communications, media, engineer, etc.)

* Does Adult 2 have professional skills or talents to share with the community? (i.e. Art, music, legal, communications, media, engineer, etc.)

* Are there any interests or volunteer opportunities not listed above that you would like the Temple to know?

* Please list your other Interests and Volunteer Opportunities

Children

Unmarried children under the age of 25 who reside in the household are included in your membership. If you already have a ShulCloud account please only enter children below who are not already listed in your account.

* Do you have any children INCLUDED in your membership that are NOT listed on your account?

* Child 1 First Name

* Child 1 Last Name

* Child 1 Preferred Name

Child 1 Hebrew Name

* Child 1 Gender Identifies As

* Child 1 Date of Birth

* Child 2 First Name

* Child 2 Last Name

* Child 2 Preferred Name

Child 2 Hebrew Name

* Child 2 Gender Identifies As

* Child 2 Date of Birth

* Child 3 First Name

* Child 3 Last Name

* Child 3 Preferred Name

Child 3 Hebrew Name

* Child 3 Gender Identifies As

* Child 3 Date of Birth

* Child 4 First Name

* Child 4 Last Name

* Child 4 Preferred Name

Child 4 Hebrew Name

* Child 4 Gender Identifies As

* Child 4 Date of Birth

* Child 5 First Name

* Child 5 Last Name

* Child 5 Preferred Name

Child 5 Hebrew Name

* Child 5 Gender Identifies As

* Child 5 Date of Birth

Yahrzeit Information

* Do you have any Yahrzeits that you would like Temple Akiba to remember? *Please note you can always add/update your own Yahrzeit observances by visiting "Manage Yahrzeits" under the "My Account" tab.

* Yahrzeit 1 First Name

* Yahrzeit 1 Last Name

* Yahrzeit 1 Gender

* Yahrzeit 1 Relationship to Which Member

i.e. Father of Adult 1

* Yahrzeit 1 Date of Death

Please Select OneBefore SundownAfter Sundown

* Yahrzeit 1 Remind me on the

Please Select OneSecular DateHebrew Date

* Yahrzeit 2 First Name

* Yahrzeit 2 Last Name

* Yahrzeit 2 Gender

* Yahrzeit 2 Relationship to Which Member

i.e. Father of Adult 1

* Yahrzeit 2 Date of Death

Please Select OneBefore SundownAfter Sundown

* Yahrzeit 2 Remind me on the

Please Select OneSecular DateHebrew Date

* Yahrzeit 3 First Name

* Yahrzeit 3 Last Name

* Yahrzeit 3 Gender

* Yahrzeit 3 Relationship to Which Member

i.e. Father of Adult 1

* Yahrzeit 3 Date of Death

Please Select OneBefore SundownAfter Sundown

* Yahrzeit 3 Remind me on the

Please Select OneSecular DateHebrew Date

* Yahrzeit 4 First Name

* Yahrzeit 4 Last Name

* Yahrzeit 4 Gender

* Yahrzeit 4 Relationship to Which Member

i.e. Father of Adult 1

* Yahrzeit 4 Date of Death

Please Select OneBefore SundownAfter Sundown

* Yahrzeit 4 Remind me on the

Please Select OneSecular DateHebrew Date

* Yahrzeit 5 First Name

* Yahrzeit 5 Last Name

* Yahrzeit 5 Gender

* Yahrzeit 5 Relationship to Which Member

i.e. Father of Adult 1

* Yahrzeit 5 Date of Death

Please Select OneBefore SundownAfter Sundown

* Yahrzeit 5 Remind me on the

Please Select OneSecular DateHebrew Date

If you need to add more than 5 Yahrzeit's to your account please email the additional names to admin@templeakiba.net with the following information for each Yahrzeit.

Name of Deceased
Gender of Deceased
Name of Mourner
Mourner's Relationship to the Deceased
Deceased Date of Death and did it occur before or after sundown
Observe on Secular Date or Hebrew Date

Membership Covenant 2023/2024

Please acknowledge your acceptance by selecting "I Agree" for all statements below:

* I (we) understand that it is the practice of Temple Akiba to photograph and/or videotape attendees at various Temple events and to use those images and videos to promote the Temple in social, print and other media. By signing and submitting this membership form, I am (we are) authorizing Temple Akiba to use images and videos of my/our family and guests for such purposes.

* I (we) understand that a minimum commitment of $360 must be received by the Temple from me (us) prior to the High Holy Days in order for me (us) to register for the High Holy Day service.

* I (we) agree to maintain membership in good standing by timely fulfilling all financial commitments to Temple Akiba in order to register for High Holy Day services, attend Religious School, maintain Bar/Bat Mitzvah dates (and all other Temple benefits).

* By signing this agreement, I (we) understand and acknowledge that I am (we are) responsible for the agreed- upon commitment for the year ending June 30, 2024. I (we) also understand that if I (we) resign, my (our) membership, I (we) remain responsible for any outstanding balances, such as Religious School tuition, and/or services rendered by the Temple, Rabbi, Cantor, including dues, tuition and other fees incurred through the date the Congregation receives written notice of the resignation.

* I (we) understand that Temple Akiba is compiling an electronic membership directory which will be made available to staff and members only. I (we) understand that the purpose of the directory is to enable members to reach out to one another and stay connected. I (we) understand that the membership directory is not to be used for professional or solicitation purposes. I (we) understand that the membership directory will include the names, phone numbers, home address, adult email addresses, as well as the names and ages of my (our) children.

You may change your Membership Directory settings at any time by logging into your ShulCloud account and clicking on "Edit My Directory Listing" from the "My Account" page.

* Please Select YES or NO:

* Level of Membership

* Name of Home Synagogue

* Please list the name(s) of your child(ren) enrolled in the Temple Akiba ECC:

Emergency Contact

* Name of Emergency Contact (other than spouse)

* Emergency Contact Relation

i.e. Parent of Adult 1

* Emergency Contact Phone

Financial Selections

* Couples & Families (2-Adult) - $2,980

Couples & Families (2-Adult) - $2,980

* Singles & Single Parents (1-Adult) - $1,490

Singles & Single Parents (1-Adult) - $1,490

* Early Childhood Center ("ECC" - Must have a child enrolled in the Temple Akiba ECC) - $540

Early Childhood Center ("ECC" - Must have a child enrolled in the Temple Akiba ECC) - $540

* Adult 1 - Young Adult Membership

* Adult 2 - Young Adult Membership

* Honeymoon Special - $1,300

Honeymoon Special - $1,300

* Associate Members (High Holy Day registration will be provided upon presentation of reciprocity letter from “home” synagogue) - $800

Associate Members (High Holy Day registration will be provided upon presentation of reciprocity letter from “home” synagogue) - $800

* Building Fund - $200

Building Fund - $200

* Security Fee - $310

Security Fee - $310

Optional Memberships

Become a Member of ARZA through Temple Akiba

The Association of Reform Zionists of America is the Israel arm of the Reform Movement, representing our community to the Zionist National Institutions. ARZA’s Mission is two-fold: to center a connection to Israel in the American Reform community, and to strengthen our Movement on the ground in Israel.

ARZA Membership - $36

Temple Akiba Men’s Group

Temple Akiba Men’s Group is the organization of men of our congregation, and is open and welcoming to all. Men’s Group welcomes people to join together in friendship, and support these three pillars: Torah, Avodah, and G’meelut Chasadim (Study, Worship, and Acts of Loving Kindness) with the overall goal of benefiting our Temple and our community. Men’s Group provides a link between our homes and our synagogue while providing opportunities to serve our faith, and by so doing, to be an example to our families. Men’s Group strives to be the source of inspiration to follow various avenues of action benefiting our members, the Congregation and the global Jewish community.

Men's Group Annual Membership Dues

Akiba - $36Besht (Baal Shem Tov) - $54Ramban (Nachmanides - Rabbi Moshe ben Nachman) - $72Spinoza (Baruch Spinoza) - $90Rashi (Rabbi Shlomo Yitzcahi) - $108Hillel - $180Maimonides (Rambam) - $360Associate (Women Only) - $18Please check the appropriate box(es)

Tzedakah Society

Please consider deepening your commitment to Temple Akiba by pledging at one of our Tzedakah levels. Your generous donation over your regular membership commitment empowers us to bring an even brighter “Light” to our Temple Community and enables our children to learn, our adults to dream, and our souls to realize goodness

*Rabbi Abraham Heschel – marched for social justice in the 1960’s
*Rabbi Sally Priesand – first female rabbi ordained by an institution

* Would you like to participate in Tzedakah Society?

* Tzedakah Society Pledge

Please check this box if you wish for your donation to remain anonymous.

Total Due

* Do you need to apply for financial assistance?

Temple Akiba Financial Assistance Application

* Adult 1 Occupation

Adult 2 Occupation

* Number of Adults in Household

* Number of Children in Household

* Will you be enrolling any children in Religious School?

Number of Children Transitional Kindergarten / Kindergarten (Temple Akiba ECC Graduate) - $540 Tuition per Child

Number of Children Transitional Kindergarten / Kindergarten (non ECC Graduate) through 3rd Grade - $1,600 Tuition per Child

Number of Children 4th - 5th Grade - $2,100 Tuition per Child

Number of Children 6th Grade - $2,000 Tuition per Child

Number of Children 7th Grade - $1,300 Tuition per Child

Number of Children 8th - 9th Grade - $1,300 Tuition per Child

Number of Children 10th Grade (Confirmation) - $1,400 Tuition per Child

Number of Children 11th - 12th Grade - $1,300 Tuition per Child

* Please enter the total amount you are able to pay towards Membership Dues, Mandatory Fees, and Religious School for the 2023/2024 Membership Year (Please indicate if this amount is monthly or annually)

* Please enter the total amount you are able to pay towards Membership Dues and Mandatory Fees for the 2023/2024 Membership Year (Please indicate if this amount is monthly or annually)

* Explanation for requested reduction: In the space below please provide a brief explanation of the circumstances that lead you to apply to dues and/or religious school reduction. Financial Secretary will contact you for clarification if needed.

* I have received financial assistance from Temple Akiba in prior years

Monthly Income

* 1099 / W-2 Income

* Investment / Rental Income

* Social Security

* Alimony

* Other Income

Monthly Expenses

* Rent / Mortgage

* Household Expenses

* Private School Tuition

* Other Expenses

Note: We hope that your financial situation improves, at which time we request you contact us so we can adjust your dues accordingly.

I agree that the above information is true and accurate and that I/my family are truly in need of financial aid for this membership year, ending ending June 30, 2024.

I also understand that I will be required to set up an automatic payment plan by either ACH (E-Check) or Credit Card upon approval of my financial assistance request by the Financial Assistance Committee.

On the following page please select the option to "Bill to Account". The Bookkeeper will be in touch upon approval by the Financial Assistance Committee to setup your payment plan.

Wed, May 8 2024 30 Nisan 5784