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21/22Financial Assistance Form


FINANCIAL ASSISTANCE REQUEST FORM
FOR 2021-2022

Temple Adat Elohim in keeping with its commitment to be a welcoming community is committed to a membership policy that ensures that no current or prospective member is denied membership because of financial hardship.

This year we are introducing our new Partnership Model highlighting our relationship as partners in sustaining and maintaining our sacred space and community. This new model provides flexibility to our partners to select a level of commitment that fits your individual requirements. We ask everyone to make a Partnership Commitment wit this in mind.

Scholarship is granted to individuals or families to be members of TAE whose current financial circumstances do not permit full-share payment of tuition for Religious School and/or ECC.  While each household’s situation is unique, it is hoped that all households will make supporting the temple a priority in their budget.  

If your household is in need of scholarship for the 2021-2022 fiscal year, please fully complete the attached form and return it as soon as possible.  Every effort will be made to respond to your application within 30 days.  Some applications may require meeting in person, either by phone or on zoom. All information will remain confidential.  Only the Executive Director, Vice President – Finance, and Accounting Department will have access to the application.

Please note that we are asking ALL members seeking assistance to update their information by completing this new form.

Thank you in advance for your cooperation in this process, making it possible to serve all while maintaining the fiscal integrity of the congregation. We are able to offer this assistance through the generosity of TAE members who give more than a full share.  We value the inclusion and participation of all members, working together to advance our mission to be: “a welcoming and fulfilling Jewish community embracing those who seek spirituality, knowledge, and a desire to heal the world.”

L'Shalom,

Aliza Goland
Executive Director

MEMBER INFORMATION

Please use this format:
888-555-1212.

Please use this format: 
888-555-1212.


HOUSEHOLD INFORMATION


FINANCIAL INFORMATION

Please tell us how much you pay out of pocket for medical expenses annually. Please include any our of pocket premiums not covered by an employer.

Please tell us about any other unplanned, extraordinary expenses. (e.g. unexpected home repairs, supporting an aging parent, unexpected medical costs)



COLLEGE-AGE DEPENDENT INFORMATION





FINANCIAL ASSISTANCE REQUEST

EARLY CHILDHOOD CENTER & INFANT CENTER

(including Summer Camp 2021)

In the drop down menus below, please select the EARLY CHILDHOOD CENTER program(s) in which you plan on enrolling your student(s). Please note that the tuition for each program is shown. Upon completion of this form, you will be sent a link for school registration. You can complete registration and select "Bill to my account." Your account will be billed the full standard tuition costs initially, but after your financial arrangement is completed, your account will be credited with a scholarship amount to lower the total.

Infant Center
Infant Center
Infant Center
Infant Center
Infant Center
Infant Center
Infant Center - Summer
Infant Center - Summer
Infant Center - Summer
Infant Center - 2021/2022
Infant Center - 2021/2022
Infant Center - 2021/2022

18 months to 3 years old
18 months to 3 years old
18 months to 3 years old
18 months to 3 years old
18 months to 3 years old
18 months to 3 years old
18 months to 3 years old - Summer
18 months to 3 years old - Summer
18 months to 3 years old - Summer
18 months to 3 years old - 2021/2022
18 months to 3 years old - 2021/2022
18 months to 3 years old - 2021/2022

3 - 6 years old
3 - 6 years old
3 - 6 years old
3 - 6 years old
3 - 6 years old
3 - 6 years old
3 - 6 years old - Summer
3 - 6 years old - Summer
3 - 6 years old - Summer
3 - 6 years old - 2021/2022
3 - 6 years old - 2021/2022
3 - 6 years old - 2021/2022

RELIGIOUS SCHOOL

In the drop down menus below, please select the RELIGIOUS SCHOOL program(s) in which you plan on enrolling your student(s). Upon completion of this form, you will be sent a link for school registration. You can complete registration and select "Bill to my account." Your account will be billed the full standard tuition costs initially, but after your financial arrangement is completed, your account will be credited with a scholarship amount to lower the total.


PAYMENT INFORMATION


B'NAI MITZVAH PLEDGE

Please type your name in this box as your signature.

PAYMENT PLEDGE

Please type your name in this box as your signature.

Wed, December 1 2021 27 Kislev 5782