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Membership FormComplete and mail to: Kol Ami: NVRC, PO Box 1801, Annandale, VA 22003 |
Kol Ami: NVRC is committed to community participation over financial obligation. The suggested annual dues are only $525 per adult or $950 per family. Those able to contribute more are encouraged to do so, and those who cannot contribute the suggested amount will be given equal membership status. Membership includes the cost of tickets for Kol Ami’s High Holiday services. The membership year is July 1st - June 30th. Please print, complete, and mail this form with your contribution to the address above.
| Name: | ___________________________________________________________ |
| Second Adult: | ___________________________________________________________ |
| Address: | ___________________________________________________________ |
| City/State/Zip: | ___________________________________________________________ |
| Home Phone: | _____________________ | Home Email: | _____________________ |
| Office Phone: | _____________________ | Office Email: | _____________________ |
| Phone preference: | Home____ Office____ | Email preference: | Home____ Office____ |
Children:
| Name | Sex | Age | Grade |
|---|---|---|---|
Contribution:
Please apply the enclosed contribution towards:
| __ | Individual Membership ($495 suggested dues) | $____ |
| __ | Family Membership ($895 suggested dues) | $____ |
| __ | Additional Contribution to Support Kol Ami | $____ |
| Total Dues / Contribution | $____ |
I/We wish to make an additional pledge to support the growth of the Kol Ami, The Northern Virginia Reconstructionist Community of $__________ by (date) ___________.
A check must accompany this form, payable to Kol Ami: NVRC. Contributions are tax deductible.