Recurring Payment Authorization Form

Welcome to Congregation Tifereth Israel. Please complete this form to set up a recurring payment from either your checking account or your credit card. Please remember that our fiscal year goes from July 1 - June 30. Your statement will show past amounts due, as well as current year amounts.

If you would like to discuss the amount of your dues, please reach out to our executive director, Laura Moskow Sigal. She can be reached at 614-928-3269 or Lmsigal@tiferethisrael.org. She would be happy to help you set up a financial arrangement that works for you. We are committed to ensuring that members are not turned away due to the inability to pay. Please reach out to Virginia Terry if you have any questions about your specific dues or payments that have been made. She can be reached at vterry@tiferethisrael.org or (614) 928-3288..

Date*

Name*

First Last

Member ID

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Recurring Payment Authorization Form

Recurring Payment Authorization Form

Automatic Payment Plan Options

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Please complete EITHER the ACH or Credit/Debit Card Authorization

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