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Membership Renewal 2022-2023 by Check
Please verify reCaptcha before submitting the form.
This form is ONLY to use if you'd like to pay your membership dues by check. If you prefer to pay online by credit card, please
use this form
. If you would like to renew your membership using a physical form, you may print it
here
. If you have any questions about renewing your membership, please
contact Josh Ashley at JAshley@anschechesed.org
.
*
First Name
*
Last Name
*
Email
Please provide the mailing address you would like us to use for all physically mailed shul communications. If you change your mailing address during the year, please help us update our records by emailing
JAshley@anschechesed.org
or calling 212-865-0600 x202.
*
Mailing Address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
If you live outside of the US, please write your address below and write NA in the Address boxes above
*
Adult/s in Membership
Please write the names of the adults included in your membership
Child/ren in Membership
Please write the names and ages of the children included in your membership
Ansche Chesed offers several membership options:
Individual Membership, for single adults without children
Family Membership, for married or partnered couples living together with or without children, and for single adults with children.
Full-Time Student Membership
Out-of-Town Membership, for anyone living outside the New York metropolitan area.
Individual and Family Membership dues vary based on income, as detailed
here
or when selecting your membership below. These membership options include High Holiday tickets.
Please note that Full-Time Student and Out-of-Town Memberships do NOT include High Holiday tickets. Please
contact the office
if you are a Student or Out-of-Town member who would like to attend High Holiday services.
After two years, we are returning to assigned seats for the High Holidays. Services are planned to be at full capacity and masked, subject to change as conditions require.
To make High Holiday seat requests, please scroll down this form after completing your membership information (unless you have selected a Full-Time Student or Out-of-Town Membership, with which they are not included).
*
Select Your Membership Type
Please select one
Individual Membership, for single adults without children
Family Membership, for married or partnered couples living together with or without children, and for single adults with children. Children must be up to age 25. Children age 26 or older will need a separate membership
Full-Time Student Membership - $150 Annual Dues
Outof-Town Membership, for anyone living outside the New York metropolitan area - $250 Annual Dues
Please note that there is a mandatory additional $180 security fee added to all membership pledges of $1,000 and higher
*
Please select your membership dues pledge (for Individual Membership)
Please Select One
Annual Income: $0-$49,999; Annual Dues: $700
Annual Income: $50,000-$59,999; Annual Dues: $850
Annual Income: $60,000-$69,999; Annual Dues: $1,040
Annual Income: $70,000-$79,999; Annual Dues: $1,200
Annual Income: $80,000-$89,999; Annual Dues: $1,360
Annual Income: $90,000-$99,999; Annual Dues: $1,520
Annual Income: $100,000-$109,999; Annual Dues: $1,680
Annual Income: $110,000-$119,999; Annual Dues: $1,840
Annual Income: $120,000-$129,999; Annual Dues: $2,000
Annual Income: $130,000-$139,999; Annual Dues: $2,160
Annual Income: $140,000-$149,999; Annual Dues: $2,320
Annual Income: $150,000-$199,999; Annual Dues: $2,625
Annual Income: $200,000-$249,999; Annual Dues: $3,150
Annual Income: $250,000-$299,999; Annual Dues: $4,262
Annual Income: $300,000-$399,999; Annual Dues: $4,550
Annual Income: $400,000-$499,999; Annual Dues: $4,725
Annual Income: $500,000+; Annual Dues: $4,950
Other (please specify below)
*
Please select your membership dues pledge (for Family Membership)
Please Select One
Annual Income: $0-$49,999; Annual Dues: $770
Annual Income: $50,000-$59,999; Annual Dues: $955
Annual Income: $60,000-$69,999; Annual Dues: $1,170
Annual Income: $70,000-$79,999; Annual Dues: $1,350
Annual Income: $80,000-$89,999; Annual Dues: $1,530
Annual Income: $90,000-$99,999; Annual Dues: $1,710
Annual Income: $100,000-$109,999; Annual Dues: $1,890
Annual Income: $110,000-$119,999; Annual Dues: $2,070
Annual Income: $120,000-$129,999; Annual Dues: $2,250
Annual Income: $130,000-$139,999; Annual Dues: $2,430
Annual Income: $140,000-$149,999; Annual Dues: $2,610
Annual Income: $150,000-$199,999; Annual Dues: $2,887
Annual Income: $200,000-$249,999; Annual Dues: $3,487
Annual Income: $250,000-$299,999; Annual Dues: $4,675
Annual Income: $300,000-$399,999; Annual Dues: $5,075
Annual Income: $400,000-$499,999; Annual Dues: $5,400
Annual Income: $500,000+; Annual Dues: $5,775
Other (please select below)
*
Please write your membership dues pledge here
Please add an additional $180 security fee to your total pledge, which we will add a charge for on your account. It can be included in the same check as your dues payment.
Please note that there is an additional $180 security added to all pledges of $1,000 or higher, which we will add a charge for on your account if applicable. It can be included in the same check as your dues payment.
Please let us know below how many High Holiday Service tickets you are requesting, and which Minyan you would like to attend services with.
Individual Memberships entitle you to one ticket. Family Memberships entitle you to one ticket for each adult (up to two) and one ticket for each dependent child between the ages of 6-25. Children under 6 do not require a ticket.
Additional tickets for extended family members and adult children (ages 26+) are available for $175 each.
*
Which Minyan Service Will You Be Joining For In-Person High Holiday Services?
Please Select One
Sanctuary Service
Minyan M'at / Hirsch Hall Service
West Side Minyan / 5th Floor Service
I am not requesting High Holiday seats
*
Number of High Holiday Service Tickets Needed (Included in Membership)
0
1
2
3
4
5
6
7
8
9
10
How many in-person High Holiday Service tickets are you requesting? For this number, please only include the tickets included in your membership: Individual Memberships entitle you to one ticket. Family Memberships entitle you to one ticket for each adult (up to two) and one ticket for each dependent child between the ages of 6-25. Children under 6 do not require a ticket.
*
Additional Sanctuary High Holiday Tickets ($175 each)
Please Select One
0
1
2
3
4
5
6
7
8
9
10
How many
additional
in-person High Holiday Sanctuary Service tickets are you requesting?
*
Additional Minyan M'at High Holiday Tickets ($175 each)
Please Select One
0
1
2
3
4
5
6
7
8
9
10
How many
additional
in-person Minyan M'at High Holiday Service tickets are you requesting?
*
Additional West Side Minyan High Holiday Tickets (available free of charge)
Please Select One
0
1
2
3
4
5
6
7
8
9
10
How many
additional
in-person West Side Minyan High Holiday Service tickets are you requesting?
*
Sanctuary High Holiday Service Seating Assignment
Please select one
I/We would like the same assigned seats as in 2019 (the last in-person High Holiday services) and understand that, to be honored, this request must be received by August 1, 2022
This is my/our first time attending with assigned seats OR I/we would like different assigned seats than in 2019
All seats in the Sanctuary are reserved for services on the 1st day of Rosh Hashanah and on Yom Kippur. Services on the 2nd day of Rosh Hashanah are open seating.
*
If you would like different assigned seats, please select which level of the Sanctuary you would like tickets for
Please select one
Main Level
Balcony
No preference
Please note that while we will try to honor your location preferences, we cannot guarantee that we can fulfill any location requests
*
Please select which area of the Sanctuary Main Level you would prefer to sit in
Please select one
No preference
1
2
3
4
5
6
7
8
Please see a diagram of our Sanctuary seating arrangement by clicking
here
. Note: we cannot guarantee that we will be able to accommodate your preference.
*
Please select which area of the Sanctuary Balcony you would prefer to sit in
Please select one
No preference
A
B
C
D
Please see a diagram of our Sanctuary seating arrangement by clicking
here
. Note: we cannot guarantee that we will be able to accommodate your preference.
Please note any special accommodations needed (main level, aisle seat, etc), or anything else we should know
Please make a note of the amount you have pledged for your annual dues, as well as the additional $180 security fee and any additional tickets ($175 each) if applicable.
You can either drop off or mail a check to Ansche Chesed at 251 West 100th Street, New York, NY 10025.
Click the blue "Submit" button below when ready.
Contact the office
with any questions.
If you are paying via charitable foundation or stock transfer, rather than a personal check, please note below along with anything we should know to identify your check when it arrives.
Sat, April 20 2024
12 Nisan 5784
Sat, April 20 2024 12 Nisan 5784
