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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 2022-23

 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 2022-2023 year is $3,200.


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. 

Additional Giving Opportunities
Gift Membership

Consider pledging membership for your friends or family members who are not currently a part of our community. Your pledge (no matter the amount) will cover their membership for the next fiscal year and we will reach out separately to welcome them to the community. We have provided enough space for 2 gift memberships below, but if there are more you'd like to include, please reach out to Jessica Biber (jbiber@adatariel.org.) 

Annual Campaign

Consider pledging now for your annual giving contribution. Thank you so much in advance for your generosity!
 

Important Payment Information
Once you hit submit, you will be prompted to select your method of payment on your pledge. You can select to pay in full or set up installments. This form is not complete without payment processed on the next page. If you cannot make a payment today, please reach out to Jessica Biber (jbiber@adatariel.org) as soon as possible for assistance.

Please note: you are asked to submit at least 20 percent of payment towards your pledge by September 1, 2022 at the latest. High Holy Day access/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.

If you will be paying using a 3rd party, please answer the questions below. If you plan to donate any investments, please contact Natalia Reznik at nreznik@adatariel.org to get information on our Merrill donation account.

Please call the office at 818-766-9426 if you have any questions or you need the information for our Merrill account.
Total 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:

Wed, December 7 2022 13 Kislev 5783