Membership and Financial Commitment Form
for Fiscal Year: June 1, 2017 thru May 31, 2018

If you are not yet a Member, please do not use this form; instead, please submit a New Membership Registration.

If you have already submitted your commitment form and would like to make a payment towards your existing annual flexible financial pledge, please go to the online donation page.

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Household Members

Adult Household Members (maximum of two, including yourself. Please enter full names):

Children living in Household:

Financial Commitment

As member(s) of Peninsula Sinai Congregation, I/we pledge to contribute the amount indicated below to PSC to support all its programs, services, facilities, clergy and staff for fiscal year June 1, 2017 thru May 31, 2018.

* The “sustaining” amount is the average amount needed from each of PSC’s current 297 member households to fully pay the budgeted expenses that our congregation approved for fiscal year 2017/18.  Please consider paying more than the “sustaining” amount to cover shortages from congregants who don’t have the means to pay this amount.

Payment Options

What are my payment options? You may pay by:

Check: When you receive your statement(s) in the mail, send a paper check

• Credit card: We accept this payment method for your convenience, but please note that PSC is charged a transaction fee (about 3%) for each credit card payment. Please let us know if you can help us cover this cost:

For your convenience, we can charge your credit card according to your designated payment plan. Please call the office to set this up: (650) 349-2816.

Alternatively, you can pay your contribution on the online donation page

Additional Comments
Electronic Signature

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