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A Historic Progressive Conservative Congregation in Valley Village, CA
A Dynamic Jewish Early Childhood Center Serving Children Ages 6 Weeks to Entering Pre-K
A Jewish Day School serving students in Grades TK-6
A Historic Progressive Conservative Congregation in Valley Village, CA

New Membership Application 2020-21

 IMPORTANT:

Please be sure to enter your information EXACTLY as you want it to appear on your account. Please do not type in all caps and be sure to double check before submission. Thank you in advance! 
 
CONTACT INFORMATION

Information for Adult #1

Parent's Information

Yahrzeits Observed

Please note that we have provided room for 3 Yahrzeits on this form. If you require more, you will be able to provide additional information once your form is submitted and your account is active.


Information for Adult #2

Parent's Information

Yahrzeits Observed

Please note that we have provided room for 3 Yahrzeits on this form. If you require more, you will be able to provide additional information once your form is submitted and your account is active.


Children's Information

First Child
 

Second Child
 

Third Child
 

Membership Commitment & Enrollment Information

Our Suggested contribution level is based around a "Sustaining Level," which is the average amount needed from each member household to sustain the operations, facilities, programs, and services at Adat Ari El. This excludes Adat Ari El schools, which will continue to remain funded primarily though tuition. The endowment remains independent.

This Year's Sustainability Amount:

Our Sustainability amount for the 2020-2021 year is $2900.

The minimum contribution for all members/member families is $500.


Recognition on the Annual Giving Wall is offered to those who contribute at or above the Sustaining amount.


Please enter the exact amount you wish to pledge for membership in the space provided below each giving level. This section is required. If you do not enter an amount here, your membership form is not complete and we will follow up with you. Please keep in mind there is a minimum contribution of $500 for the 2020-2021 year. 
"Other" is any amount over $500. Please keep in mind there is a minimum contribution of $500 for the 2020-2021 year.
Payment Method Selection
Please note: if you select "bill to my account" you will be invoiced upon form completion and are asked to submit at least 20 percent by September 1, 2020 at the latest. If you bill to your account, any High Holy Day tickets/experiences will be withheld until payment of at least 20 percent has been made on your account. If you require special arrangements, please contact our accounting department at nreznik@adatariel.org.
Total Membership Amount:

Subscriptions/Interests


Please let us know if you are interested in starting or joining a program not already listed (for instance: mahjong, book club, hiking group, etc.) We will take your considerations into account when planning programming if we have enough interest.

Check all that apply.

Chavurot
Please separate names with a comma

Adat Ari El Security Information

Emergency Contact Information

Primary Emergency Contact

Secondary Emergency Contact

Vehicle Information

Please note that you will only receive a vehicle sticker in the mail if you fill out information for each vehicle. We require license plate information. Additional vehicle sticker requests may be submitted to the office and we encourage you to call for assistance if you require additional stickers.

If you walk or bike to campus or don't own/operate a motor vehicle, please write "None" in the required fields below. You will receive a Walk-On Security Pass from our office if we see this in your form. 

First Vehicle

Second Vehicle

Third Vehicle


In applying for Adat Ari El membership, I agree to conform to the By-Laws and to honor all monetary pledges to the congregation. (If you would like a copy of the By-Laws sent to you via e-mail, please contact the office.)

Please sign electronically below:

I/We understand that all resignations from Adat Ari El MUST be received in writing by the administrative office no later than 30 days prior to the effective resignation date. 

Please sign electronically below:

Tue, September 22 2020 4 Tishrei 5781