New Member Form 2024-2025

Welcome! Whether you have been connected to CBI for years or are new, we are delighted to have you as a member.

Thank you for supporting CBI by making a commitment to membership. We are grateful to be co-creating this community with you! The participation, volunteerism, and financial support of members are essential to the sustenance of our Jewish community and campus.

PLEASE READ BEFORE BEGINNING:
Please log into your account by clicking “Login” at the top of the page (if it says Welcome with your name, you are already logged in). If you already receive CBI emails then you are in our system; please use that email address and select “reset password” to set up your account and log in. If you have never received CBI emails, please either complete this form or reach out to us at office@cbinorthampton.org.

Logging in will allow you to chose your payment methods and frequency. If you would like to set up quarterly or monthly payments, please make sure the number of payments equals the number of months until June 30 (end of membership/fiscal year). You can pay online with bank ACH or credit/debit card. If you prefer to pay by check, please make sure you are logged in, then choose "bill to account" in the payment section after submitting this form.

Our Membership and fiscal year runs from July 1 to June 30. If you join partway through the fiscal year, please feel free to prorate your dues based on the month you join and adjust the amount accordingly (for example pay 50% if joining in January or 25% if joining in April).

Membership Contribution

We are deeply grateful for your membership contribution at whatever level you are able to offer.

We ask community members who are able to pay $205 per month ($2,460 per year) or more to please do so. This is necessary in order for other members to pay less and to sustain an economically diverse community. We recognize that each community member's circumstances are unique and we ask that you contribute at the highest level that your heart and financial ability will allow.

When determining your fair-share contribution, you will consider the following factors:

Your household income. Reflect on your household income, your current financial resources, and their relationship to your ability to give. The median household income in Northampton is around $80,000.
Your relationship with money. Consider your financial commitments including caregiving responsibilities, disability-related costs, or access to generational wealth.
Your personal values. Reflect on how you want to support the local Jewish community now and for the future.
Sliding scale. Those with greater financial resources are asked to contribute more, while those with less access to wealth should contribute according to their means.

Are you ready to learn more about how to determine your Fair Share dues?

NoYes, open the self-assessment tool

You know your financial situation better than any scale could ever measure*

FAIR SHARE SELF-ASSESSMENT

This is a short quiz to help you determine your fair share. It's totally anonymous and does not get submitted to or read by anyone but you. There are so many elements of class and access that are not included in these few questions, so please just use this as a general guide to think about your access to resources (or lack thereof) and make an honest and self-loving evaluation.

NOTE: As you read through, jot down your answer for each question on a piece of paper, so you can examine it at the end.

1. GENERAL EXPENSES/STANDARD OF LIVING

I can cover my basic needs and plenty of extras, I take multiple vacations, time off, may own/rent a higher-end home/car, I am able to easily access Jewish community for myself and/or afford Jewish education for my child(ren)/grandchild(ren), I am able to donate comfortably to causes that matter to me
I can cover my basic needs and regular extras, I take an annual vacation without financial burden, my debt does not prohibit attainment of basic needs, I am able to access Jewish community for myself and/or afford Jewish education for my child(ren)/grandchild(ren), I am able to donate modestly to causes that matter to me
I can cover my basic needs and occasional extras, I have enough savings to cover three months of expenses, I actively save to afford a holiday, I save and budget to access Jewish community for myself and/or Jewish education for my child(ren)/grandchild(ren), I sometimes can donate a small sum to one or two causes that matter to me
I can cover my basic needs and nothing else, I have limited financial savings, I struggle to afford reliable transportation, I rely on discounts to access Jewish community for myself and scholarships to pay for Jewish education for my children
I struggle to cover my basic needs, I sometimes skip necessities, use government assistance programs, have debt that prohibits my basic needs, my housing may be insecure or low quality, I use scholarships or am often unable to access Jewish community for myself and/or Jewish education for my children.

2. ANNUAL INCOME

When thinking of your annual income, consider employment income, interest, dividends, Social Security, IRA, pension, 401(k), rental income, business profits, etc.

Household annual income over $150,000, or individual income over $100,000
Household annual income between $100,000 and $250,000, or individual income between $75,000 and $100,000.
Household annual income between $75,000 and $100,000, or individual income between $50,000 and $75,000.
Household annual income between $50,000 and $75,000, or individual income between $30,000 and $50,000.
Household annual income less than $50,000, or individual income less than $30,000.

3. CAREER (if applicable)

My career is stable and moving forward
My career is stable
My career is unstable or I don't have a career but will in the future
I have a job, not a career
I am underemployed or rely on temporary gigs

4. STUDENT LOANS (if applicable)

My loans are paid off or I went to school without loans
I am paying student loans for professional / post-secondary education in my current field
I am playing student loans and most people in my family have higher education
I am paying student loans and I'm the first person in my family to go to college
Was unable to pursue post-secondary education due to finances

5. MY FAMILY OF ORIGIN HAS ASSETS SUCH AS

Investments / multiple properties
A home that is paid off / retirement income
A home that they're paying for
No assets or no access to family of origin
My family of origin requires my financial help

6.IMPACT OF IDENTITIES

My race, ethnicity, gender, ability or other identities positively impact or does not impact my income
Mostly 1
Somewhere in the middle
Mostly 5
My race, ethnicity, gender, ability or other identities negatively impact my income

7. IMPACT OF CBI ON YOUR LIFE

CBI plays a big role in my and my family’s spiritual and/or social nourishment. It’s a cornerstone of my faith, community, and moral support
I/my family attend weekly services and classes at CBI, and it's an important part of our weekly routine and social life
I/my family enjoy attending CBI events and social gatherings and it connects me to my Jewish identity and community
I/my family engage for only for High Holidays or might not step foot on campus very often, but I am glad CBI is there when I need it
CBI could close tomorrow, and it would not change anything about my/my family’s life

NOW GO BACK THROUGH THE ANSWERS AND SEE HOW MANY OF EACH LETTER YOU CIRCLED

Mostly 1's	Tier 1	$3,600+sustainer pledge	$300/month +sustainer pledge
Mostly 2's	Tier 2	$2,700-$3,600	$225-$300/month
Mostly 3's	Tier 3	$2,250-$2,700	$187.50-$225/month
Mostly 4's	Tier 4	$1,350-$2,250	$112.50-$187.50/month
Mostly 5's	Tier 5	$60-$1,350	$5-$112.50/month

Note: If you are able, please consider a household pledge of at least $2,460/year or $205/month. This is the median pledge needed to support CBI for 2024-2025.

Member Information

* Number of Adults Joining as Members

* Primary Applicant First Name

* Primary Applicant Last Name

Preferred Name or Nickname

* Date of Birth

Pronouns

Hebrew Name

Ben/Bat/M'Beit

Parent 1 Hebrew Name

Parent 2 Hebrew Name

* Address Line 1

Address Line 2

* City

* State

* Zip Code

Home Phone

Mobile Phone

Work Phone

* Email

Occupation

Company/Work Name

If married, anniversary date.

Previous Synagogue Affiliation (if any)

Concurrent Synagogue Affiliation (if any)

* I understand my name and contact information will be added to the online member directory. I also understand I can update or remove that information by signing into my online account.

I understand my name and contact information will be added to the online member directory. I also understand I can update or remove that information by signing into my online account.

Partner or Spouse First Name (if applicable)

Partner or Spouse Last Name (if applicable)

Preferred Name or Nickname

Date of Birth

Pronouns (optional)

Hebrew Name

Ben/Bat/M'Beit

Parent 1 Hebrew Name

Parent 2 Hebrew Name

Address Line 1

Address Line 2

City

State

Zip Code

Partner or Spouse Mobile Phone

Partner or Spouse Email

Occupation

Company/Work Name

Spouse or Partner Work Phone

Previous Synagogue Affiliation (if any)

Concurrent Synagogue Affiliation (if any)

I understand my partner/spouse's name and contact information will be added to the online member directory. I also understand I can update or remove that information by signing into my online account.

Please feel free to share more about yourself and what has drawn you to CBI.

Child 1 First Name

Child 1 Last Name

Preferred Name/Nickname

Birthday

Hebrew Name

Pronouns

Child 1 Email

Is child living at the main address?

yesno

If no, indicate the address where the child lives.

Name of School

Current Grade

Are you interested in enrolling your child in ALMA (religious school)?

yesno

Child 2 First Name

Child 2 Last Name

Preferred Name/Nickname-Child 2

Birthday-Child 2

Hebrew Name-Child 2

Pronouns-Child 2

Child 2 Email (if applicable)

Is child living at the main address?

yesno

If no, indicate the address where the child lives.

Name of School

Current Grade

Are you interested in enrolling your child in ALMA (religious school)?

yesno

Child 3 First Name

Child 3 Last Name

Preferred Name/Nickname-Child 3

Birthday-Child 3

Hebrew Name-Child 3

Pronouns-Child 3

Child 3 Email (if applicable)

Is child living at the main address?

yesno

If no, indicate the address where the child lives.

Name of School

Current Grade

Are you interested in enrolling your child in ALMA (religious school)?

yesno

Child 4 First Name

Child 4 Last Name

Preferred Name/Nickname-Child 4

Birthday-Child 4

Hebrew Name-Child 4

Pronouns-Child 4

Child 4 Email (if applicable)

Is child living at the main address?

yesno

If no, indicate the address where the child lives.

Name of School

Current Grade

Are you interested in enrolling your child in ALMA (religious school)?

yesno

If you have additional children, please list their information here.

Yahrzeit Information

It is custom of the congregation to read the names of loved ones who are no longer with us on the anniversary of their passing. You will be notified via mail from the CBI Office of the Hebrew date of your loved one’s death unless you specify the English/Gregorian date.

Do you wish to submit yahrzeit names and receive notices of the anniversary of their passing?

NoYes

Yahrzeit 1 First Name

Yahrzeit 1 Last Name

Yahrzeit 1 Hebrew name

Please write the relationship (mother, father, etc) and the name of the mourner (your name, spouse's name, etc)

Yahrzeit 1 Date of Passing

Time of Passing

Before sundownAfter sundown

Yahrzeit 2 First Name

Yahrzeit 2 Last Name

Yahrzeit 2 Hebrew name

Please write the relationship (mother, father, etc) and the name of the mourner (your name, spouse's name, etc)

Yahrzeit 2 Date of Passing

Time of Passing

Before sundownAfter sundown

Yahrzeit 3 First Name

Yahrzeit 3 Last Name

Yahrzeit 3 Hebrew name

Yahrzeit 3 Relationship to Applicant

Yahrzeit 3 Date of Passing

Time of Passing

Before sundownAfter sundown

If you wish to submit additional yahrzeit names and dates, please type in the details here. Please include the secular (English) date of death.

Opportunities for Connection

I (we) am (are) interested in learning more about getting involved with the following committees:

I (we) am (are) interested in volunteering at CBI on an occasional basis.

Help prepare and serve kiddush lunchGreeter for Shabbat servicesSet up and clean up for events and programsMake dinners for community members who are sick or mourningVisit the sick in the hospitalProvide rides for community membersSecurity team and door coverage for services and eventsRead Torah/Haftorah at servicesHelp with office tasks

“Havurah: An Experiment in Jewish Gathering” is an initiative hosted by Congregation B’nai Israel that supports the development of homegrown, peer-led, Jewish gatherings. The goal of this initiative is to provide a platform for people to fill in gaps they experience in current Jewish programming and offerings by providing the structure and support for gathering and forming mini-communities that foster deep, caring, supportive relationships.

Viist the CBI website havurah page to learn more about the current groups: www.cbinorthampton.org/havurah.

Please indicate which groups you would like to learn more about:

Notes or comments about volunteering, committees, or havurot interest and availability.

Please write any special talents, interests or ideas you wish to share with us to better serve the congregation:

Please decide on the dues amount that makes sense for you and write the amount below.

* I would like to pay Fair Share Dues for the Membership Year from July 2024-June 2025:

Note: If you join mid-year, please feel free to prorate your dues total.

Payment Options

Online:
- ACH - no fees - to set up a recurring payment, please log in
- Credit/Debit Card - convenience fee - to set up a recurring payment, please log in
Offline:
- Check/IRA/DAF/Other - no fee - must be logged in to your online account and select "Bill to Account" - Please make checks out to Congregation B'nai Israel with "Membership Contribution" in the memo line. Checks can be mailed to or dropped off at 253 Prospect Street, Northampton, MA 01060.

Please select this box if you will make your membership dues contribution by sending us a check.

Please submit your application after signing below and complete the payment section of this application.

* Type Signature

* Date

Tue, April 1 2025 3 Nisan 5785

Congregation b'nai israel 253 prospect street, northampton, ma 01060 (413) 584-3593

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