Membership Application / Contribution Form
5769 (Sept. 2008 - Sept. 2009)
Congregation Kona Beth Shalom
Shari J. Berman ◊
President ◊ 75-5512 Mamalahoa Hwy. ◊ Holualoa, Hawaii 96725 ◊ Phone: (808)
322-1638
Your
name:_________________________
Name
of Spouse or Partner:______________________
Children
under
18, with names and dates of birth:________________________
______________________________
Address: ______________________________
City: ______________________________
Home phone: _________________ Work phone: ________________ Fax: _________________
Mobile phone: ________________ E-mail: ______________________________
please print all above clearly
| Membership Contribution: | Suggested non-member Contribution: | ||
| Sustaining Membership | $396 |
Children under 18 |
complimentary |
| Family Membership | $288 | High Holiday Services only | $60 per person |
| Single Membership | $180 | High Holiday Services (Kama'aina) | $36 per person |
At Yizkor, please remember the following persons:
______________________________
______________________________
______________________________
Yizkor Contribution $18 (or any amount): $ _________
Hebrew and Torah Studies (HATS)
Children's Hebrew Education Program: $ _________
Building Fund Contribution: $ _________
Total enclosed:
Please make your check payable to Congregation Kona Beth Shalom and mail it along with this Application to:
68-3840 Lua Kula St. #E 204
Waikoloa, HI 96738-5788
No one will be turned away from services for inability to pay.
Please call Shari Berman (322-1638) or Joel Gimpel (325-4991) if you have any questions.