New Member Form 2023/2024

New or Returning Member?

New Member of CBB - Welcome!Returning Member of CBB - Thank you for your continued membership!

Campaign Id

Account Id

First Name

Last Name

Email Address

Phone

Street

City

State

Zip Code

Member Date of Birth

Member Pronouns

Member Occupation/Profession

Member Employer Name

Member Religious Background

Please upload a current picture of yourself for our confidential, internal database. This helps us with communication and will not be shared outside of our organization. Please ensure the picture is just of you, ideally a head-shot, low resolution is acceptable.

JSON for Primary Member

Would you like to add a second adult member for your household?

Yes, please add another adult to my membershipNo, there are no other adults to add to my membership

Are you a single parent household?

Yes, we are a single parent householdNo, we are not a single parent household

Second Member Information

Second Member's First Name

Second Member's Last Name

Second Member's Email Address

Second Member's Cell Phone

Second Member Date of Birth

Second Member Pronouns

Second Member Occupation/Profession

Second Member Employer Name

Second Member Religious Background

Please upload a current picture of yourself for our confidential, internal database. This helps us with communication and will not be shared outside of our organization. Please ensure the picture is just of you, ideally a head-shot, low resolution is acceptable.

JSON for Secondary Member

Do you have dependent children?

Yes, I have dependent childrenNo, I do not have dependent children

How many dependent children do you have?

Repeatable Child Section

Child First Name

Child Last Name

Child Birth Date

childJSON

Child 1

Child 1 First Name

Child 1 Last Name

Child 1 Birth Date

Child 2

Child 2 First Name

Child 2 Last Name

Child 2 Birth Date

Child 3

Child 3 First Name

Child 3 Last Name

Child 3 Birth Date

Is your mailing address different than your street address?

Yes, I have a different mailing addressNo, my mailing address is the same

Mailing Address

Mailing Street

Mailing City

Mailing State

Mailing Zip Code

Member JSON

Contact JSON

Member JSON for Submission

Membership Details

New Member Details

Primary reason for joining CBB at this time:

Friends and family members that belong to CBB:

Is there anything else you would like us to know about your family, your special interests, or needs you may have?

Would you like to acknowledge a Yahrtzeit?

Yes, I have one or more yahrtzeits to acknowledgeNo, I do not want to add any yahrtzeits to acknowledge

YAHRTZEIT - Anniversary of an immediate family member's passing

Which date do you prefer to observe?

Hebrew dateEnglish date

First Name of Loved One

Last Name of Loved One

Date of Death

Observer

MemberSecond MemberIndicate the name of who is observing the Yartzeit here

Member Name

Second Member Name

Relationship

Who was the loved one to this observer?

Yahrtzeit JSON

Authorization and Release for Use of Information and Photographs:

I grant Congregation B'nai B'rith (CBB) permission to use my name, photographs, videos, and testimonials of me and my family in CBB's promotional, marketing, program materials and media, for public relations purposes. (Type initials below to indicate consent).

Yahrtzeit and Member Details JSON

Yahrtzeits Submission JSON

Yahrtzeit JSON for Submission

Member Details JSON for Submission

Membership Page

Membership Categories

Standard $3,700
Family $3,100 for families with children enrolled in BHY Preschool or Jewish Learning Programs
Individual $2,100
Affiliate $1,300 primary membership is at an out-of-town synagogue
OpenDor $400 per young adult (20s & 30s)
Alternative

Leadership Giving (includes annual membership)

Membership contributions provide nearly half of CBB’s annual operating budget. Leadership Donors ensure that we keep our doors open for all to participate regardless of financial situation. Leadership Donors are invited to special gatherings and receive recognition throughout the year.

Sustainer $5,500
Rabbi's Circle $10,000
Rabbi's Circle "Chai" $18,000
Builder $25,000
Pillar $50,000
Visionary $100,000

Membership Selection

Membership or Leadership Amount

$

Alternative Membership Amount

Optional Contributions

Security - to help offset costs associated with keeping our community and campus safe.

Building Fund - Every new member is assessed a one-time fee of $3,000 to help maintain our campus and facilities. This is typically paid within the first five years of membership, however a longer payment plan can be established if needed.

Membership Amount Plus Options

$

Membership JSON

Membership JSON for Submission

Invoice JSON

ARZA - optional $50 for The American Reform Zionist Association.

Yes, please add $50 to my total.

Are you making your gift anonymously?

YesNo

How would you like your name listed?

Would you like to go paperless? If you select "Yes" you will receive membership renewal materials via email next year.

Yes - I want to receive my materials via email onlyNo - I want to receive a mailed renewal packet

Would you like your membership to be automatically renewed each year? If you select "Yes" you will be invoiced for the same membership level in July of next year.

Yes - sign me up for auto renewalNo - I do not wish to automatically renew my membership

Additional Donations JSON

Invoice JSON

Additional Donations JSON for Submission

Payment Page

Payment Information

Payment Method

I will pay by credit cardI will send a check via mail (including an IRA distribution)Stock or Mutual Fund

Note: Your credit card will be charged 5 days from the date you submit this form.

Please make your check payable to CBB and mail to:

CBB
Attn: Membership
1000 San Antonio Creek Road
Santa Barbara, CA 93111

Transfer to Vanguard DTC #0062 ACCT #12462664 FOR: CBB Corp.
Please contact Terry Grimes at terry@cbbsb.org upon transfer.

Credit Card Fees

Please consider a courtesy tax-deductible contribution of 3% to offset credit card processing fees.

Yes, I am covering the fees.No, I am not covering the fees.

3% Contribution

$

Membership plus 3% contribution

$

Total Amount

$

Payment Schedule

Frequency (Credit or Debit Card)

1 Payment in Full3 Payments (1x a month for 3 months)4 Payments (1x a month for 4 months)

Frequency (Check)

1 Payment in Full

Number of Installments

Amount to be paid now / 1st Installment:

$

Amount paid per future installment:

$

Credit Card Information

First Name on Card

Last Name on Card

Credit Card Number

Exp. Month

MM

Exp. Year

YYYY

Security Code

Different Billing Address

Use a different billing address than your membership address above?

NoYes

Billing Address

Billing Street

Billing City

Billing State

Billing Zip Code

Special Instructions

Thank you and welcome to CBB!

Payment JSON

Invoice JSON

Payment JSON for Submission

Member Details Submission JSON

Salesforce JSON for Submission

Salesforce Household JSON for Submission

final JSON

Invoices

	Item (Designation Description)	Price (Assessed Amount)	Designation Id	Campaign Id	Builder
Membership Amount
Leadership Amount
Membership Building Fund
Membership Security
Additional Donation
Credit Card Fee

Office Use - HIDDEN

AUTHORIZE_DOT_NET_CREDIT_CARD_SUFFIX

AUTHORIZE_DOT_NET_STATUS

Gateway Address

Gateway City

Gateway State

Gateway Zip

Gateway Quantity

Gateway Amount

Gateway Installment Amount

Gateway Number of Installments

Gateway Number of Months Between of Installments

Gateway Amount is Final Membership / Frequency or 0 if not credit.

Connector Variables (UPDATE DEFAULT VALUES EACH YEAR) - HIDDEN

Membership End Date

Membership Start Date mapped to today's date to capture the actual date the membership began

Outreach Id

Invoice Owner User Id

User Id for notification of non-member registrations

Invoice / Designation Name

Auth.net Subscription Name

Auth.net Item Description

Tax Deductible Text (Used In Email Auto-Responder)

Authnet_Hidden_Fields