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JOINING DARCHEI NOAM

MEMBERSHIP (& SCHOOL REGISTRATION) FORM STARTS BELOW

We are delighted you have chosen to join our Darchei Noam community this year.
 

We hope that you will find membership an enriching experience and encourage you to explore the diverse opportunities for Jewish expression that Darchei Noam offers.

Please call upon us whenever we can assist you in becoming a larger part of our
Darchei Noam community. Please call or text Nancy Bolton in the office at (267) 405-1582 if you have any questions or need assistance in filling out this application. All information in this application will be treated confidentially. No need to struggle with this form, PLEASE REACH OUT to Nancy Bolton, Synagogue Director - 267-405-1582 (text/phone) or nancy@darcheipa.org.

Voluntary Community Support

MEMBERSHIP

Individual Membership = 1 adult 

Family Membership = 1 or 2 adults & household/college age children 

Please see the sustaining amount for our membership types below.
Please consider becoming a Sustaining Member of Darchei Noam. It costs the synagogue approximately $1100 per adult (26 & older) to run Darchei Noam at its most minimal effectiveness. To ensure we can keep this vibrant community alive, this year, we highly encourage as many members as possible to be Sustainers!


Darchei Noam offers 3 types of voluntary dues memberships - 

1. Primary Membership - in-person & virtual access

Sustaining Contribution:
  • $1100 ($92/month) / one adult
  • $2200 ($183/month) / family (more than one person on the account)

2.Virtual Membership- for those too far to attend in-person

Sustaining Contribution:
  • $800/adult ($66.70/month)
  • $1600/family (133.34/month)

3. Secondary Membership - not ready to leave your synagogue, but interested in still supporting and participating with Darchei Noam (not attending High Holidays at DN)

Sustaining Contribution:
  • $500/adult ($41.67/month)
  • $1000/family (83.33/month)

Remember - no amount you would like to contribute is too much!!

Questions about membership amounts?
  • Nancy Bolton (nancy@darcheipa.org or 267-405-1582) -Synagogue Director

PLEASE START YOUR
MEMBERSHIP REGISTRATION HERE


Please Note: 
5786 Membership runs from July 1, 2025 to June 30, 2026. 
Note for school parents: Membership is required to register your children for 2025-26 (5786) Shul School (MM-6) and/or Teen Chayim (7-10).

All items in this form marked "REQUIRED" must be completed before moving to the payment screen.

What do the different levels mean?

  • Sustainer Levels - helps us cover the costs of security, maintenance, synagogue activities, salaries, High Holy Days, and general operating expenses.

  • Community Builder Membership  - increase your commitment to $5000 for a full family membership plus a donation to support our  synagogue and congregants

  • Chesed Chevra Membership -increase your commitment to to $3600 ($300/month) full membership plus a donation to the synagogue to help support scholarships for membership & school

 

NEW OR RETURNING MEMBER


 

MEMBERSHIP TYPE

CHOOSE FROM THE DROPDOWN SELECTIONS BELOW:
Required

 

VOLUNTARY CONTRIBUTION AMOUNT

REQUIRED
 
REQUIRED

Add the amount only, no $ sign

Adult & Children Info:
ADULTS (2 MAX) & CHILDREN (25 & UNDER)


REQUIRED 
  • 1 Form per Account - 2 Adults and Household/College Children (25 and under)
  • Additional Adults - Please use a separate form for new membership

REQUIRED 

Membership is REQUIRED to enroll in school.
Please continue on this form for both membership and school registration.
 
PERSONAL INFORMATION

ADULT MEMBER INFORMATION


RENEWING MEMBERS - Adult information (not children) will be filled in for you if you are renewing. You may overwrite these fields. If a field below is blank, then our system does not have your information. Please complete the field with your information.

NEW MEMBERS - Please fill out all fields.
 
Adult 1
(Required)
 
Adult 2
(Required)
 
Adult 1
 
Adult 2
Adult 1
(Required)

 
Adult 2
(Required)
 
Adult 1 - Confirmation of your renewal will be sent here.
(Required)

 
Adult 2
(Required)
Adult 1
(Required)

 
Adult 2
(Required)
 
Adult 1
(REQUIRED)

 
Adult 2
(REQUIRED)

 
Adult 1 
Type in Hebrew or English
 
Adult 2
Type in Hebrew or English
 
Father of Adult 1
Type in Hebrew or English
 
Father of Adult 2
Type in Hebrew or English
Mother of Adult 1
Type in Hebrew or English


 
Mother of Adult 2
Type in Hebrew or English

 
Adult 1 (&2)
 
Adult 1 (&2)


 
Adult 1 (&2)
Adult 1 (&2)

 
Adult 1

 
Adult 2

 
Adult 1
(Required)
 
Adult 2
(Required)
 
Adult 1
(if applicable)
 
Adult 2
(if applicable)
Adult 1 (&2)
if applicable
 
Adult 1
 
Adult 2
 
Community Involvement 
Adult 1

Please indicate ANY areas of interest during this coming year 25-26.
Community Involvement 
Adult 2

Please indicate ANY areas of interest during this coming year 25-26.

 

 
Adult 1
(Are you good at construction? Writing grants? Creating decorations? Playing an instrument? etc)
Adult 2
(Are you good at construction? Writing grants? Creating decorations? Playing an instrument? etc)
SERVICE GREETER (USHER) - Adult 1
 
Would Adult #1 be willing to serve as a greeter / usher at a Shabbat service?

Greeters and ushers play a vital role in creating a warm and welcoming environment. Responsibilities may include welcoming attendees, handing out prayer books, assisting clergy with small tasks, and helping with both setup and cleanup for the Oneg or Kiddush.

Please note that all families who are having a B'nai Mitzvah during the year will be asked to greet at another child's B'nai Mitzvah service.

Our staff or volunteers will be in touch regarding available services & dates.

 

Adult 1
 
SERVICE GREETER (USHER) - Adult 2

Would Adult #2 be willing to serve as a greeter / usher at a Shabbat service?

Greeters and ushers play a vital role in creating a warm and welcoming environment. Responsibilities may include welcoming attendees, handing out prayer books, assisting clergy with small tasks, and helping with both setup and cleanup for the Oneg or Kiddush.

Please note that all families who are having a B'nai Mitzvah during the year will be asked to greet at another child's B'nai Mitzvah service.

Our staff or volunteers will be in touch regarding available services & dates.

Adult 2
 
CHILDREN INFORMATION
Please complete all fields. 
Child 1
Child 1

 
Child 1
(required if enrolling in school 3rd grade & up)
Type in Hebrew or English
 
Child 1 
Child 1 - past, present or future
Leave blank if n/a.
 
Child 1
Child 2
Child 2
Child 2
(required if enrolling in 3rd grade & up)
Type in Hebrew or English
 
Child 2
Child 2
 
Child 3
Child 3

 
Child 3
(required if enrolling in school 3rd grade & up)
Type in Hebrew or English

 
Child 3

 
Child 3 - past, present or future
Leave blank if n/a
 
Child 3

 
Child 4
Child 4
 
Child 4 
(required if enrolling in school 3rd grade & up)
Type in Hebrew or English
 
Child 4
Child 4
 
Child 5 (and more)
If you are joining with 5 or more children, please add the 5th+ childrens' information in the box above. (Name, Hebrew name, bday, pronouns, and gender)

MADRICHIM PROGRAM

The Madrichim program is a voluntary program for 8th-12th graders at Darchei Noam. It is a leadership and mentorship initiative where our teen assistants support younger students (Mini Mensch to 6th grade) in our Shul School on Sunday from 9am-12pm. These teens, known as madrichim (Hebrew for "guides" or "leaders"), help our teachers with classroom activities, provide individualized attention to students, and develop valuable teaching and leadership skills. Our program offers training during Shul School hours to equip our madrichim with strategies for engaging students, fostering inclusion, and assisting learners with diverse needs.

(8th-12th Grade Only)

Please add the name of your teens above that are interested in this voluntary program.

 
YAHRZEIT INFORMATION

A yahrzeit marks a loved one's passing in the Hebrew calendar. Observances may include lighting a candle, reciting Kaddish with a minyan, giving Tzedakah, and visiting the gravesite.

Darchei Noam notifies our members of upcoming yahrzeits (those listed on your account) and recites their names during services. We also offer tzedakah opportunities to honor your loved ones through Memorial Plaques ($360) in the sanctuary and by adding their names to the Yizkor Book ($54).

Members can add a yahrzeit of a loved one in the "My Account" section, or you can provide details on this form during renewal, and we will enter it for you. You may also contact the office at any time during the year for help in adding a new yahrzeit to your account.
 

Required
 
PLEASE INCLUDE ALL 4 ITEMS BELOW:
  1. Name of deceased 
  2. Gregorian date of death mm/dd/yyyy (year is required)
  3. Relationship to congregant
  4. Please advise if the passing was before of after sunset (affects the Hebrew date)
  5. (Hebrew Name if you have it, not required)
 
 Memorial Board Plaques                        


Memorial Plaques ($360 each) honor loved ones at Darchei Noam. Displayed in the sanctuary, they include a memorial light lit on Yom Kippur and your loved one's Yahrzeit.

Select the number of plaques you wish to purchase today from the dropdown—$360 per plaque will be added to your total. We will follow up upon receipt. If you rather not purchase today, please leave the number on "0".

PLEASE SEND PLAQUE DETAILS TO THE DARCHEI NOAM OFFICE.

Turnaround time from purchase: 4-6 weeks (typical), 8-12 weeks before High Holy Days and Yizkor.


If you prefer to wait to pay, the memorial plaque order form is located on our website. You may access the form throughout the year.
 
LEV SHALEM SIDDUR  


$65/Siddur

Many of our congregants (both adult and children) choose to purchase their own copy of the Lev Shalem Siddur to bring to Shabbat services or use when participating virtually.

A copy of the Lev Shalem prayerbook is required for children enrolling for the first time from 4th grade to their B'nai Mitzvah. 

Please choose how many copies of Lev Shalem you would like to purchase (if any). 

 
   # of Lev Shalem Prayerbooks to add to my total
PARENTS OF NEW 4TH GRADE STUDENTS & UP - $65 each - Siddur Lev Shalem for Shabbat is mandatory for NEW 4th graders to B'nai Mitzvah age. Please include this Siddur in your Prayerbook order if you currently do not own your own copy.
SCHOOL ENROLLMENT INFORMATION

(If you are enrolling a child, ALL INFORMATION IN THIS SECTION IS REQUIRED)
SCHOOL FEES
 

2025-26 Shul School  & Teen Chayim Tuition and Fees: 

  • $900 + $60 material fee / Mini Mensch (MM) - 2nd grade
  • $1300  + $60 material fee/ 3rd - 6th grade
  • $65 Lev Shalem Siddur fee / 4th grade+
    • (Only If you are new to Darchei Noam or if you would like another copy) Please make sure you purchased a copy of the siddur up above on the form.
  • $1030 / 7th grade
    • (B'nai Mitzvah Fees are billed separately. Please reach out to Nancy Bolton, B'nai Mitzvah Coordinator, if you have any questions regarding B'nai Mitzvah -bnaimitzvah@darcheipa.org)
  • $930 / 8th - 10th grade (Confirmation Trip fees are billed separately)
 


 
1st Child
2nd Child
3td Student
4th Student

 
1st Student
 
2nd Student
3rd Student
4th Student

 

Student 1
Required 

Student 1
(3rd-6th grade ONLY)
 
Student 1
Required

Student 2
Required 

Student 2
(3rd-6th grade ONLY)
 

Student 3
Required 

Student 3
(3rd-6th grade ONLY)
 
Student 3
Required

Student 4
Required 

Student 4
(3rd-6th grade ONLY)
 
Student 4
Required
Student 1
(IEP, Gifted, medical diagnoses, mental health diagnoses, new mental health assessments, allergies, vaccines, asthma, etc)
Required
 
Student 2
(IEP, Gifted, medical diagnoses, mental health diagnoses, new mental health assessments, allergies, vaccines, asthma, etc)
Required
 
Student 3
(IEP, Gifted, medical diagnoses, mental health diagnoses, new mental health assessments, allergies, vaccines, asthma, etc)
Required
 
Student 4
(IEP, Gifted, medical diagnoses, mental health diagnoses, new mental health assessments, allergies, vaccines, asthma, etc)
Required
EDUCATIONAL CONSIDERATIONS

In the text box(es) below, please note if your child(ren) receive(s) any education services, such as IEP, Gifted/Talented (GIEP), Adaptive Equipment, Special Education, Outside Tutoring, Physical / Occupational Therapy, One-on-One Aide* (Wrap-Around Services), Behavioral Support, etc.
 
*Will you have an outside aide present at Darchei Noam?

 
MEDICAL INFORMATION
DIAGNOSES OR ASSESSMENTS

In the text box below, please note if your child(ren) is/are diagnosed as having, or is/are being assessed for any mental or medical diagnosis in which they have been given a 504 Plan or if you anticipate this will impact their learning at Shul School (i.e. ADHD, Autism Spectrum, Speech/Language Disability, Emotional/Behavioral, etc.)
Student 1
Student 2
Student 3
 
Student 4
Student 1
 
Student 2
Student 3

 
Student 4

 
Student 1
 
Student 2
Student 3

 
Student 4
 
SCHOOL DISCLAIMER
 

If we or our emergency contact(s) cannot be reached in the event of a medical emergency, we hereby give permission to the physician or hospital selected by the school or its selected representative, to hospitalize and/or secure proper treatment for our child(ren) named above. We understand that any costs incurred will be our responsibility.

From time to time, limited information about your child(ren) may be disclosed beyond the scope of Darchei Noam. This may include the release of students' ages, grades, images, artwork, writing or other school related work to the media for publicity, displays, newsletters, etc. If you do not consent to the release of information, you must notify the synagogue office by completing the photo release below.
 

Required
 
EMERGENCY CONTACT INFORMATION 
 

Please list two people that we may contact in the event we are unable to reach a parent in an emergency.

THIS IS A REQUIRED SECTION
 


 

 

Please click the box if in agreement.
 

Please click the box if in agreement.
 
Please add names and relationship to child in the box.

 
  
Photo/Video Authorization (aka Darchei Noam Photo Release)

Pictures of our members and member's children (particularly during Shul School, Teen Chayim and child/family events) happen during the year by our staff and volunteers for multiple purposes for both internal and external communications/marketing. This can include Darchei Noam marketing materials/brochures, newsletters, synagogue website, social media (Facebook, Instagram, YouTube, etc), newspaper articles, Exponent advertisements and/or educational materials. 

Please indicate if we have permission for members of your family to be in pictures and videos.  Please note that this choice will remain in place 2025 and beyond until we receive a change in writing.

*disclaimer: identification of individuals in photos is done manually. If you decline permission, but see a photo of you or your child, please contact the Communications & Marketing Director asap so it can be removed.

If you choose NO, please upload a picture or send a picture of your family to our Communications Director, Nancy Bolton, so that we can identify your faces and remove you from photos/videos.


 

REQUIRED 
PEANUT, TREE NUT and KASHRUT AWARENESS POLICY


We have a number of congregants (members and students) who suffer from severe peanut/nut allergies. Even trace amounts of a problem food can cause a life-threatening allergic reaction.  

Please help us maintain a safe community by keeping all peanuts/nuts and peanuts/nuts products out of the synagogue and school (peanuts, walnuts, almonds and all other tree nuts). Even those foods labeled with “may contain" or "traces of" in the list of ingredients can be harmful. We appreciate your assistance in making the school safe for every student.

While we strive to be a peanut/nut aware facility, we cannot guarantee that you or your child will not come into contact with products containing peanuts/nuts. Every reasonable effort will be made to provide a peanut/nut aware environment at Darchei Noam. Our staff cannot be held responsible. The ultimate responsibility lies with the members, parents and students to ensure their safety. It is therefore important that if you or your child has serious allergies, inform us upon registration, and provide any necessary instructions and an EpiPen.

Darchei Noam also works to be inclusive to the Jewish community's needs for Kosher dietary laws. Our synagogue and events related to our synagogue are all dairy/pareve and meat free. If an event is serving meat, it will be held outside the building and no dairy will be served at that event. 
 

ADDITIONAL DONATIONS TO DARCHEI NOAM FUNDS
 

If you wish to make an additional voluntary dedicated donation to any of our Darchei Noam funds (outside of your Voluntary Community Contributions for membership), please enter any amount into the box under the name of that fund. Thank you for your generous support! Any amount is extremely appreciated.

If you select yes, you will see the following funds listed for additional donations: 

  • General Fund - General support of Darchei Naom programming and expenses
  • Security Fund - Supports our security system and in-person building guards
  • Religious School Fund - Materials, scholarships and other support of our Shul School/Teen Chayim
  • Rabbi's Discretionary Fund - Used for tzedakah, chesed and to support programs at the Rabbi's Discretion
  • Hazzan's Discretionary Fund - Supports the Hazzan's efforts to build our musical community
  • Building Fund - Supports our efforts to maintain & clean our building, purchase equipment & furniture, as well as continue plans for possible expansion to the top floor
  • Engagement Fund - Provide's support for subsidization of  congregational meals and refreshments during events
  • Chesed Chevra Fund - Provides for needs of families experiencing loss or illness
  • Adult Education Fund - Funds our congregation's adult learning/speakers, etc

CHOOSE YES TO ADD $$ AMOUNTS INTO YOUR SELECTED FUNDS
 
General support of Darchei Noam programming and expenses
Materials, scholarships and other support of our Shul School
Supports our efforts to maintain and clean our building, purchase equipment and furniture, as well as continue plans for possible expansion
Supports our security system and security guards
Supports the Hazzan's efforts to build our musical community
Used for tzedakah, chesed and to support programs at the rabbi's discretion
Provides support for congregational meals and refreshments
Provides for needs of families experiencing loss or illness
Funds our congregation's adult learning/speakers, etc.
Payment & Billing Information


On the next page, you will be presented with payment options. Please review the following carefully:

Payment options include credit card, ACH/e-check, Check, Venmo or IRA/Securities.

DEPOSIT REQUIREMENTS:

  1. The first payment of your total balance (membership, tuition and donations) is required to join the synagogue and/or register for school.

STEPS FOR PAYMENT:

Credit Card/Installment Payment Options: If paying by credit card or e-check, you may choose to:
  1. Choose your credit card or ACH/E-Check already on file (if you have set these up prior to renewal) or
  2. Add a New Credit Card or ACH/E-Check.
  3. Pay the full amount in one payment, or
  4. Split your balance into installment payments (selectable on the next page).
  5. Click Confirm & Continue
  6. NOTE: You must have an installment plan in place on a credit card or e-check if you are enrolling your child in school
VENMO PAYMENTS: 
  1. On the Confirm Payment page, choose "Bill to Account" and submit.
  2. Send your Venmo payment (minimum deposit amount) to @darcheinoam.
  3. If you will be paying in installments or later in the year, a 5% deposit will be due within 30 days.
  4. Please let our Synagogue Director, Nancy Bolton, know if you have any questions (Note: You MUST have an installment plan in place if you are enrolling your children in school.)
CHECK PAYMENTS: 
  1. On the Confirm Payment page, choose "Bill to Account" and submit.
  2. Make your check out to "Darchei Noam" and write (Membership/School on the memo line. (Just Membership if there is no school enrollment)
  3. Please send your payment to Darchei Noam, 211 W Butler Pike, Ambler, PA 19002.
  4. If you will be paying in installments or later in the year, a 5% deposit will be due within 30 days.
  5. Please let our Synagogue Director, Nancy Bolton, know if you have any questions (Note: You MUST have an installment plan in place if you are enrolling your children in school.)

IRA OR STOCK PAYMENT OPTION (for additional payments only)

  1. On the Confirm Payment page, choose "Bill to Account"
  2. Please email the office at info@darcheipa.org if you have any financial questions (Note: You MUST have an installment plan in place if you are enrolling your children in school.)

PAYMENT SOURCE (ON FILE) REQUIREMENTS:

  1. Regardless of your chosen payment method, you are required to keep a valid credit card OR e-check on file at all times. By completing this form, you authorize Darchei Noam to charge this card for any missed or overdue payments.
  2. Account Updates: If your credit card or bank information changes during the year, per this agreement, you agree to update Darchei Noam immediately to avoid missed payments.
  3. Accuracy of Information: By submitting this form, you affirm that all information provided in the entire form is accurate and up to date to the best of your knowledge.

 


REMINDER - School registrants may choose only credit card or E-Check and select their number of installments. If you are registering for school and wish to pay by another means in 1 full installment before September, please choose "Bill to Account" and contact Emily to discuss (emily@darcheipa.org)
 
CREDIT CARD ON FILE

This card will remain on file to be available once you are a member to you to use for future payments for events, purchases, rsvp's, dinners, etc.


If you prefer to call the office with your credit card information vs. adding it here to this form, please call Nancy at 267-405-1582,

if you know you already have a card on file, please skip adding it here.
 
       This acknowledgment is required.
 

The card added in this section will not be billed at this time. It is only to be kept on file and billed in case of an outstanding balance or missed payment. To make payments by credit card for your total on this form, add your credit card on the payment screen that appears when you hit submit or use your existing card on file.

 

 
FINAL FORM SIGNATURE 
PLEASE ADD YOUR FIRST & LAST NAME
 
REQUIRED


 
ANYTHING ELSE TO ADD?
Please feel free to let us know if you have plans to be away for several months, if you are looking forward to a particular event, if you have a particular volunteer position that you want to help with, or anything else that would help us provide a good experience overall for you in the coming year.
TOTAL AMOUNT OWED
This # does not include the transaction fee if you pay by credit card or e-check. The total with this fee will be displayed on the next page.To be paid in full by June 30, 2026
 
Includes Voluntary Community Support, (memberhsip contributions), school registration fees and any additional donations or fees you specify (except for the credit card or e-check transaction fees)

 

IMPORTANT!!!! 

Please read before submitting - 

Please scroll to the top and confirm you can see ALL of the information you completed on this form IS VISIBLE above.ONLY the information that you can see right before hitting submit will show to Darchei Noam.

Please click the button below to be taken to the Confirm Payment screen.

IF YOU CAN NOT SUBMIT (Save & Move to Payment Screen) - Review all Required Fields (These fields have a * and the word required under them)

If this still does not work, check again. You ARE missing a required field.

If you are still having trouble, please contact Nancy at nancy@darcheipa.org or text (call) the office at 267-405-1582. DO NOT STRUGGLE OR SPEND A LOT OF TIME TRYING TO SUBMIT. CALL NANCY!!

 

Sat, December 13 2025 23 Kislev 5786