Membership Application 2020-2021

* First name

* Last name

First name

First name of partner or spouse

Family name

Family name of partner or spouse

* Address

Apt., Suite, PO Box, Floor

* City

* State

* Zip code

Primary person email address

Email of partner or spouse

Home phone

Mobile phone

Primary person mobile phone

Mobile

Mobile phone number of partner or spouse

Benefactor

$4,000.00

In addition to household membership, you may receive 2 tickets to Casino Night, and 4 tickets to any brunch, lecture, or movie that USH offers throughout the year.

Household

$1800 - 2 adults plus any number of children under the age of 21
$ 200 - Security Fee - $100 per adult

Individual

$900 - 1 adult plus any number of children under the age of 21
$100 - Security Fee per Adult

Senior

First personSecond person

$400 plus $100 security fee

If you are a senior (70 and older) select "first person" for yourself. If there are 2 adults in your family , also select "second person."

Under age 30, or full-time student

First personSecond person

$200

Special discounted membership for under age 30, or full time student

Alumni

First person alumniSecond person alumni

$50 for each adult in this category.

Alumni category is for those who were members of USH and have moved out of our area. Please note that High Holy Day tickets are not included in this category.

I wish to make an additional donation to support USH during these unprecedented circumstances

Please enter the monetary amount you wish to donate.
Thank you for your generosity and commitment to USH and our community.

When you have completed the application, and completed the payment details, please go to your account page. There you can enter the names and birth dates of your children, and the names of those loved ones whose yahrzeit you wish to be reminded of. If you need help, please contact the VP Membership.

Total

Thu, January 28 2021 15 Shevat 5781