Please fill out the form below.

    If you check option 4 or 5, you need not complete the remainder of this questionnaire.
  • Personal Information

  • CONGREGATIONAL INFORMATION

  • DETAILS OF POSITION

  • FINANCIAL INFORMATION

  • * Be sure to EXCLUDE medical benefits, pension, convention allowance, professional dues, and honoraria. * Be sure to INCLUDE fair rental value of your residence if you are living in a synagogue owned home.
    (If so, please be sure you included the fair annual rental value in the figure provided in E1) also If you answered YES to the above question, please answer the following question.