Pay Dues & Notification Preference

"*" indicates required fields

Annual Sisterhood Dues $36*

Dues Year*

2022-2023

2021-2022

Your Name*

First Last

Billing Address*

Street Address Address Line 2 City State ZIP Code

Email Address*

Mobile Phone*

Phone - Landline

Notification Preferences: Please notify me about upcoming Sisterhood events/programs by (select one):*

Email notification

Postal mail notification

Payment Method*

Pay by credit card or debit card

Pay by check

Please submit this form and mail your check (payable to "Beth Shalom Sisterhood") to:

Beth Shalom Sisterhood
Attn: Staci Kahn
14913 Catalina St
Leawood, KS 66224

Would you like to add an amount to cover the credit card convenience fee?

Yes - let me add a 5% contribution

Additional contribution to cover the credit card convenience fee

Price: $0.00

Total

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

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