Join Us or Renew Your Membership - Kolot Mayim Reform Temple

Kolot Mayim Reform Temple Membership Application

Step 1 of 5

20%

Membership(Required)

New Member

Renewing Member

Today's Date

MM slash DD slash YYYY

Address(Required)

Street Address Address Line 2 City Province Postal Code

First Adult Member

Name(Required)

First Last

Email(Required)

Phone(Required)

Hebrew Name

Second Adult Member

Name

First Last

Phone

Hebrew Name

Children

Do you have children under the age of 18?(Required)

Yes

First Child

Name

First Last

Date of Birth

MM slash DD slash YYYY

Hebrew Name

Second Child

Name

First Last

Date of Birth

MM slash DD slash YYYY

Hebrew Name

Third Child

Name

First Last

Date of Birth

MM slash DD slash YYYY

Hebrew Name

Yahrzeit Information

Does your family have Yahrzeits to observe?(Required)

Yes

Are there any Yahrzeit changes from last year?(Required)

Yes

Please only list the Immediate Family members you have lost (parents, children, siblings, spouse) If you are renewing your membership ONLY PROVIDE CHANGES FROM LAST YEAR.

Observing Yahrzeit for

Hebrew Name (if applicable)

Relationship (eg. mother of Jon Schwartz)

Civil Date of Death

MM slash DD slash YYYY

Hebrew Date of Death

Next Yahrzeit

Observing Yahrzeit for

Hebrew Name (if applicable)

Relationship (eg. mother of Jon Schwartz)

Civil Date of Death

MM slash DD slash YYYY

Hebrew Date of Death

Next Yahrzeit

Observing Yahrzeit for

Hebrew Name (if applicable)

Relationship (eg. mother of Jon Schwartz)

Civil Date of Death

MM slash DD slash YYYY

Hebrew Date of Death

Next Yahrzeit

Observing Yahrzeit for

Hebrew Name (if applicable)

Relationship (eg. mother of Jon Schwartz)

Civil Date of Death

MM slash DD slash YYYY

Hebrew Date of Death

Privacy Policies

Kolot Mayim Reform Temple’s privacy policy can be found on our website at https://kolotmayimreformtemple.com/privacy-policy/ The information you provide to us is used to provide services and to keep you informed of Kolot Mayim activities , including programs, services, events, funding, volunteering, and more . Your personal information may be shared where required by affiliated organizations within the Reform Movement. Safeguards are in place to ensure that the information is not improperly disclosed or is shared more widely than is necessary to achieve the purpose for which it was collected. We also maintain the integrity of this information to protect it from being lost or stolen. Unless required by law, we do not provide personal information to third parties, except as above and as specified in the privacy policy.

Do you consent to having your photo published?(Required)

Yes

Do you consent to having your Yahrzeit information published in our newsletter or announced at services?(Required)

Yes

Questions or concerns relating to Kolot Mayim Reform Temple’s privacy policy should be e-mailed to: km@kolotmayimreformtemple.com attention: Privacy Officer. Further information on privacy and your privacy rights may be found on the website of the Office of the Information and Privacy Commissioner for British Columbia: www.oipc.bc.ca.

Membership Categories

Family Membership: Two adults one of whom is Jewish and their children who are under the age of 26. Dues are $1640.00.

Single Parent Family Membership: Jewish adult and children under the age of 26. Dues are $820.00

Individual Membership: Jewish Adult. Dues are $820.00.

Student Membership: Jewish Adult over 18 and younger than 30, attending a post secondary institution full time. Dues are $105.00.

Out of Town Family Membership: Two adults one of whom is Jewish and their children under the age of 26. The family does not live in Greater Victoria. High Holiday tickets are not included. Due are $760.00.

Out of Town Individual Membership: Jewish Adult who does not live in Greater Victoria. High Holiday tickets are not included. Dues are $380.00.

Associate Member: Jewish Adult who is a member of another Jewish Congregation in Greater Victoria. High Holiday tickets are not included. Dues are $380.00.

Friend of Kolot Mayim: Over 18 who is not Jewish. Friends are ineligible to vote. High Holiday tickets are not included. Dues are $210.00.

Please Note the Following

All memberships include ArzaCanada.org membership. Voters must be legal age of 18. Voting by proxy is not permitted. Credit Card payments are subject to a processesing fee.

Payment Options

How would you like to pay for your Membership?(Required)

By Credit Card

By Interac eTransfer

By Personal Cheque

By Extended Payment Plan

Select membership category by entering the number 1 in the appropriate Quantity Box

Family Membership Quantity

Price: $ 1,690.00 CAD

Quantity

Family Membership Quantity

Price: $ 1,620.00 CAD

Quantity

Single Parent Family Membership Quantity

Price: $ 845.00 CAD

Quantity

Single Parent Family Membership Quantity

Price: $ 820.00 CAD

Quantity

Individual Membership Quantity

Price: $ 820.00 CAD

Quantity

Individual Membership Quantity

Price: $ 820.00 CAD

Quantity

Student Membership Quantity

Price: $ 108.50 CAD

Quantity

Student Membership Quantity

Price: $ 105.00 CAD

Quantity

Associate Membership Quantity

Price: $ 395.00 CAD

Quantity

Associate Membership Quantity

Price: $ 380.00 CAD

Quantity

Out of Town Membership Quantity

Price: $ 395.00 CAD

Quantity

Out of Town Membership Quantity

Price: $ 380.00 CAD

Quantity

Friend of Kolot Mayim Quantity

Price: $ 220.00 CAD

Quantity

Friend of Kolot Mayim Quantity

Price: $ 210.00 CAD

Quantity

Fair Share Contribution

The cost of operating Kolot Mayim is greater than the income from regular membership dues. If you can pay more, that is even better since you support those who cannot. Thanks to some generous members and former members, we have been able to sustain ourselves financially. Therefore, every year we ask those members who can, to make a Voluntary Fair Share donation.

Fair Share Contribution Based on your Family Income

$50,000 to $55,000——— $185.40

$55,001 to $65,000——— $370.80

$65,001 to $72,000——— $556.20

$72,001 to $80,000——— $741.60

$80,001 to $90,000——— $927.00

$90,001 to $100,000——- $1112.40

$100,001 and up———- $1297.80

Fair Share Contribution Based on your Family Income

$50,000 to $55,000——— $180

$55,001 to $65,000——— $360

$65,001 to $72,000——— $540

$72,001 to $80,000——— $720

$80,001 to $90,000——— $900

$90,001 to $100,000——- $1080

$100,001 and up———– $1260

Enter Fair Share Contribution Here

Total

A Note about Credit Card Payments

Amounts include a 3% surcharge for service fees.

Paying by Interac eTransfer Payments

To use this method, you will need to set up the Treasurer as the recipient at kolotmayimtreasurer@gmail.com, and advise him of the question and answer (password) by separate email, including advising what you are paying for.

Paying by Personal Cheque

Forward a cheque payable to Kolot Mayim Reform Temple c/o 3636 Shelbourne Street, Victoria, BC, V8P 1H2. Please include your personal information (for tax receipt purposes) and the reason for the cheque. You may also drop off a cheque whenever the Jewish Community Centre is open (usually 11:30 to 1:30pm).

Extended Payment Plan

Please divide your total Contribution by 4. Provide four (4) cheques payable to Kolot Mayim Reform Temple. Post-dated cheques should be dated for Sept 1, 2025, Dec.1, 2025, Feb. 1, 2026, and April 1, 2026. Send cheques to Kolot Mayim Reform Temple c/o 3636 Shelbourne Street, Victoria, BC, V8P 1H2. Please include your personal information (for tax receipt purposes) and the reason for the cheque. You may also drop off a cheque or cash whenever the Jewish Community Centre is open (usually 11:30 to 1:30pm).

Untitled

First Choice

Second Choice

Third Choice

Quantity

CAPTCHA