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Membership Application

We are delighted that you have chosen to be part of our congregation. For over 170 years, members of Anshe Chesed Fairmount Temple have come together to pray, study, celebrate and support one another. We hope you find being part of our congregation an enriching experience and encourage you to explore the diverse opportunities for Jewish expression and involvement that Anshe Chesed Fairmount Temple offers. We invite you to call upon our clergy, staff and lay leaders to assist you in strengthening your connection to our community.
Please take a few moments to complete all sections of this form that apply to you.  We’d like to get to know you better.  Information about our members enables us to provide programming that meets the need of the entire temple community and helps us to identify opportunities to put your talents and passions into action.  No personal information is shared with outside organizations. 

Applicant A

Applicant B

Applicant A

Applicant B

CHILD(REN) Information


Married Children

Other Adults at Home

Member Relatives

Synagogue Affiliation

Clergy Contact

Yahrzeit Information

I am interested in learning more about the following:

Welcoming you in our Bulletin

Membership Policies

1. All new Members shall agree to an Annual Membership Commitment when applying

2. All Members when reaching age 35 years or older shall contribute to the Temple Building Fund. The Building Fund is $1500 payable over a course of five years. Please note a 10% discount will be applied if Building Fund is paid up front.

3. All new members will be automatically billed for the annual security assessment ($118).

4. Annual Membership year is July 1 to June 30.

5. A minimum payment of 25% of your total balance is necessary to process your application.

6. Beginning November we will prorate member dues.

7. You must be a member in “good standing” to be entitled to full membership privileges which include High Holiday Tickets, Religious School enrollment and access to clergy for lifecycle events.

Annual membership commitments are reviewed and adjusted at the beginning of each fiscal year.

Payment Schedule


I (we) hereby apply for membership to Anshe Chesed Fairmount Temple. If I (we) become a member, I (we) agree to abide by the By-laws, rules and regulations of the Congregation, including the timely payment of dues, fees, building fund and any other charges as approved by the Board of Directors. I (we) understand that failure to do so may result in suspension or termination of my (our) membership, but will not relieve me (us) of the obligation to pay any previously incurred dues or fees. Members must pay in full for the year in which they resign. All resignations must be in writing.

Account Details

Enter your name and e-mail address for your confirmation:

Payment Information

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