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Dues Commitment Form 2020-21

Please fill out the form below to make your 2020-21 Havurah Shalom dues commitment. If you would rather mail in a paper version, please print the file at this link and send to Havurah Shalom, 825 NW 18th Ave., Portland, OR 97209.


Click here to see dues schedule.  This will open a new window in your browser.  Please close the new window to return to this form.

(You may self-adjust to 2% of your Adjusted Gross Income--line 8b of form 1040, with a minimum of $360 for those who are 24 or older. This is the amount you wish to subtract from the standard dues amount for your membership category).  

If you are able, please help by adding to your full dues.  Members of our community have been seriously affected by the troubles in our economy.  Your extra contribution helps our Havurah remain financially healthy.

You must manually add the numbers above and enter the total dues amount into this box.

Balance due by June 30, 2021.

Please enter any notes above if you want to pass along any info. 

If dues will come from a stock donation, please write in the "Notes" box above the following information:  ______shares of _________which will come from ___________________(name of  broker).  Transfer will be made by _________(month,yr).

Thu, October 29 2020 11 Cheshvan 5781