Home > The Membership FormMembership Application1 Welcome2 Membership Information3 Member Information4 Interests and Talents5 Your Synagogue Experience6 Dues & PaymentWelcomeWelcome to Ansche Chesed, a ritually traditional, socially progressive and intellectually vibrant Conservative synagogue on Manhattan’s Upper West Side. An active, engaged center of Jewish life, our community is made up of people both passionate about Torah and tradition and dedicated to building the world through deeds of kindness. Diversity enriches us and we welcome everyone, young and old, individuals and families, traditio-nalists and seekers, LGBTQ and straight, those married to Jews and the intermarried. Membership InformationMembership Type*What type of membership?IndividualSingle adults without childrenFamilyMarried or partnered couples living together with or without children, and single adults with childrenFull-Time StudentPhotocopy of student ID and proof of full-time status requiredOut-of-Town MemberAnyone living outside the New York metro area. NOTE: This membership does NOT include High Holiday ticketsService/Minyan*Which service or minyan(s) do you attend or plan to attend? Sanctuary Service Minyan M’at West Side Minyan Minyan Rimonim Member Information First Name Last Name Date of Birth Street Address EditDelete There are no Adults. Add Adult First Name Last Name Date of Birth EditDelete There are no Children/Dependents. Add Child/Dependent Emergency Contacts*Full NameHome PhoneCell PhoneRelationship YahrzeitsFull NameHebrew NameBefore/After SundownRelationship Interests and TalentsVolunteeringVolunteering is an important aspect of our community. Please let us know if you or anyone in your family would like to be involved in any of these activities (check all that apply): Social Action Men’s Homeless Shelter Adult Programs Family and Children’s Programs Hebrew School Greeting Visitors on Shabbat Hosting Shabbat Meals Leading/Assisting with Services Reading Torah and/or Haftarah (leyning) Giving Divrei Torah (commentary) Attending Daily Morning Minyan Visiting the Sick (Bikkur Cholim) Preparing Bodies for Burial (Chevra Kadisha) Comforting Mourners (Menachem Aveilim) Communications/ Marketing Membership Fundraising/CultivationTalents and ExpertisePlease let us know if you have any talent(s) or particular expertise which could be called on to help the synagogue (check all that apply): Communications/Marketing Social Media Videography or Photography Interior Design Fundraising or Grant-Writing Systems/IT Music Employment and Nonprofit Law Nonprofit/Synagogue Management Other Your Synagogue ExperienceWhat made you choose to join or renew your membership?*What can we do to make your synagogue experience everything you would wish it to be?* DuesDues Policy and ScheduleDues provide the funds necessary for us to meet our financial obligations and support our activities. Our dues policy asks members to pay annual dues based on their income using the Fair Share Dues Schedule. If you are unable to pay the required amount, even over the course of the year, please call Executive Director Josh Hanft (212-865-0600 ext. 209) or Rabbi Jeremy Kalmanofsky (212-865-0600 ext. 210) to discuss alternative arrangements. No one will be turned away because of an inability to pay and your conversation will be kept strictly confidential.Please NoteMembership Year: Our membership year runs from July 1 – June 30 with dues payable on July 1. If you cannot pay the full amount at that time, please make as large an initial payment as possible. Full payment must be made by December 31 of the membership year.Definition of Income: Income for those who are employed is the Gross Income shown on the most recent year’s tax return. Income for couples is their Combined Gross Income shown on the most recent year’s tax return. Those who are self-employed may use the Adjusted Gross Income shown on the most recent year’s tax return, i.e. income remaining after business deductions but before personal deductions.Full-Time Student and Out-of-Town Members: Members in both groups pay a flat fee regardless of income.Supplemental Membership Fees: Membership in Minyan M’at and the West Side Minyan requires a small supplemental fee paid directly to those minyans. To learn more, please visit AnscheChesed.org or email Membership_Mat@126.96.36.199 and/or Membership@westsideminyan.org.Payment Method: You may pay by check or by credit card (VISA or MasterCard only). Payment by check earns a small discount (see dues schedule).Confidentiality: The amount of dues each member pays is kept strictly confidential.Fair Share Dues, by Membership TypeIndividual Membership: Single adults without childrenINDIVIDUALSAnnual IncomeAnnual DuesFrom ToCheck Credit Card0–$49,999$700$721$50,000–$59,999$850$875$60,000–$69,999$995$1,025$70,000–$79,999$1,145$1,180$80,000–$89,999$1,280$1,319$90,000–$99,999$1,395$1,437$100,000–$109,999$1,520$1,566$110,000–$119,999$1,665$1,715$120,000–$129,999$1,780$1,834$130,000–$139,999$1,925$1,983$140,000–$149,999$2,070$2,133$150,000–$199,999$2,190$2,256$200,000–$249,999$2,630$$250,000–$299,000$3,600$3,708$300,000 and above$3,800$3,914Family Membership: Married or partnered couples living together with or without children, and single adults with childrenFAMILIESAnnual IncomeAnnual DuesFrom ToCheck Credit Card 0–$49,999$770$794$50,000–$59,999$955$984$60,000–$69,999$1,110$1,144$70,000–$79,999$1,270$1,309$80,000–$89,999$1,435$1,479$90,000–$99,999$1,555$1,602$100,000–$109,999$1,690$1,741$110,000–$119,999$1,855$1,911$120,000–$129,999$1,985$2,045$130,000–$139,999$2,140$2,205$140,000–$ 149,9992,295$2,364$150,000–$199,999$2,410$2,483$200,000–$249,999$2,835$2,921$250,000–$299,000$3,600$3,708$300,000 and above$3,800$3,914Full-Time Students: Photocopy of student ID and proof of full-time status requiredFULL-TIME STUDENTSCheck Credit Card$150$155Out-of-town Members: Anyone living outside the New York metro area.OUT-OF-TOWN MEMBERSCheck Credit Card$175$181NameThis field is for validation purposes and should be left unchanged. 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