Financial Assistance Application 2021-2022

It is not our intention to deny membership to anyone unable to afford the established fees.

This form must be completed and submitted by June 25 2021 in order to receive assistance with your 2021-2022 membership commitment, unless there is a change in your financial circumstances during the fiscal year. Forms returned after June 25, 2021 may not be processed in time to obtain High Holy Day tickets. Please note: no financial assistance application will be considered unless this form is completed, and a member’s most recent tax return is attached.

For full details about our application process and policies please click here.

* Address

* State

* Zip Code

Home Phone

if applicable

* Member 1 - First Name

* Member 1 - Last Name

* Member 1 - Birth Date

* Member 1 - Email

* Member 1 - Cell Phone

* Is there a second adult on your account?

* Member 2 - First Name

* Member 2 - Last Name

* Member 2 - Birth Date

* Member 2 - Email

* Member 2 - Cell Phone

* How many children (under 23 years) - Including those who do not live with you and / or are in college.

* Child 1 - First Name

* Child 1 - Last Name

* Child 1 - School

* Child 1 - Age

* Child 2 - First Name

* Child 2 - Last Name

* Child 2 - School

* Child 2 - Age

* Child 3 - First Name

* Child 3 - Last Name

* Child 3 - School

* Child 3 - Age

* Child 4 - First Name

* Child 4 - Last Name

* Child 4 - School

* Child 4 - Age

* Do you have any children enrolled in our Religious School?

* Do you own your own home?

* Are you a full-time resident of Sarasota?

“As a Non-resident/Associate member you will be required to certify upon joining, and annually, that you are not a Florida resident, have no homestead exemption, no FL driver’s license, and cannot vote in FL OR provide a letter confirming your status as a full dues paying member at another synagogue.”

* Do you usually spend a significant part of the year (a month or more) away from Sarasota?

Do you own a second home?

* Do you provide financial support to someone not listed above?

If yes, please explain:

* Would you be willing to commit to be a VOLUNTEER, to help Temple Sinai?

If yes, are there any specific activities that interest you or special skills or knowledge that the Temple can use?

Please provide any additional information that you feel may be pertinent to your financial assistance application.

Please remember that any amount you can pay helps strengthen and build our community.

Proposed annualized 2021-2022 membership commitment including security fee and Building Maintenance Fund pledge (if applicable):

Please upload your most recently filed federal Form 1040, in the box below.

Sun, October 24 2021 18 Cheshvan 5782

Financial Assistance Application 2021-2022

CONTACT

4631 s LOCKWOOD RIDGE ROAD

SARASOTA, FL 34231

OFFICE@TEMPLESINAI-Sarasota.ORG | 941.924.1802

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