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Financial Hardship Variance Request

Request for Financial Hardship Variance 2021-2022
Example: Dues - $000.00/month, Religious School - $000.00/year, etc.
I/We also understand that such fees as Yotair Ivrit (Hebrew Tutoring), Bar/Bat Mitzvah fees, Confirmation fees, Room Usage fees and fees for High Holiday tickets for guests are in addition to the amounts which may be agreed upon and are not subject to adjustment. 

I/We further understand that any dues, Capital Fund or Religious School Tuition commitments (financial hardship variance plan) must be current to partake in a life cycle event, i.e., Bar/Bat Mitzvah, Confirmation, etc.
I/We understand that all payments made monthly must be made either through ACH or a credit card.

I/We agree to keep current with the Membership Dues, Capital Fund and Religious School Tuition as adjusted, and will be responsible for all prior amounts.

By selecting the "Submit" button, I/We are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature.
Tue, September 16 2025 23 Elul 5785