Family ID: 
(printed on the Dues Form that was mailed )

First Name:

Last Name:

Dues

We are asking you to pledge the amount from the Dues Table or the suggested amount on the Dues form that was mailed to you, whichever is higher.  But, if, as a result of personal financial circumstances, both amounts exceed your ability to pay, arrangements should be made with the Finance Committee.  This committee is dedicated to confidentially meeting the needs of individual members while also meeting the financial obligations of the congregation as a whole.  Either e-mail donminer@tds.net or check the box below if you wish to be contacted by the Finance Committee.

Dues Amount:      
I want to talk to the Finance Committee

High Holiday Seat Preferences

# of Front Seats     # of Back Seats

Please reserve the same seats as last year if possible

Comments/Special Needs: