Dues Assistance Application

Confidential Application for Dues Assistance

Congregation Beth Or is committed to enabling all who seek to join us to do so regardless of their financial abilities. We strive to make the process to obtain assistance as easy and unobtrusive as possible. We ask for the following information so that we can work with you to develop a fair financial solution that is manageable for your family.

Please be assured the information shared in this application will be kept in strict confidence.

If you prefer to get in touch directly, please don't hesitate to do so.

Phil Nordlinger, Executive Director
215-646-5806

Congregant Information

First Name

Last Name

Phone Number

Address Line 1

Address Line 2

City

State

Zip Code

Request Information

* I/we hearby apply for relief from the scheduled dues and fees for the fiscal year, beginning July 1 of the current year.

I/we hearby apply for relief from the scheduled dues and fees for the fiscal year, beginning July 1 of the current year.

* Fiscal Year:

Why are you requesting assistance? Please share your specific situation:

Financial Information

What is your gross income and from what source?

What is your proposed payment?

Sat, September 7 2024 4 Elul 5784