Rising Tide Membership & Renewal Are you a new or returning member?* I am signing up for a new membership I am renewing an existing membership Please select a membership category* Organizational Membership Individual Membership Our organization met with the Rising Tide Manager within one week of today ($25 discount)* Yes No Please select a type of new Organizational Membership* Flowing Waters Sustaining Member: Support the open mikveh movement & be recognized ($600) Established Mikveh: Our community is currently operating a mikveh and has a budget at or over $50,000 ($450) Established Mikveh: Our community is currently operating a mikveh and has a budget under $50,000 ($340) Emerging Mikveh: Our community is in the process of developing a new open mikveh ($340) Aspiring Mikveh: Our community is in our first year exploring the creation of a new open mikveh ($180) Please select a type of new Organizational Membership with discount* Flowing Waters Sustaining Member: Support the open mikveh movement & be recognized ($575) Established Mikveh: Our community is currently operating a mikveh and has a budget at or over $50,000 ($425) Established Mikveh: Our community is currently operating a mikveh and has a budget under $50,000 ($315) Emerging Mikveh: Our community is in the process of developing a new open mikveh ($315) Aspiring Mikveh: Our community is in our first year exploring the creation of a new open mikveh ($155) Please select a type of renewal Organizational Membership* Flowing Waters Sustaining Member: Support the open mikveh movement & be recognized ($600) Established Mikveh: Our community is currently operating a mikveh and has a budget at or over $50,000 ($450) Established Mikveh: Our community is currently operating a mikveh and has a budget under $50,000 ($340) Emerging Mikveh: Our community is in the process of developing a new open mikveh ($340) Please select a type of Individual Membership* Mikveh Guide: I am a future, current, or former Mikveh Guide, facilitating Jewish ritual water immersion for others ($54-$180 annually — Suggested amount: $100) Mikveh Supporter: I am a community partner, ambassador, and/or enthusiastic learner about open mikveh, and I am not yet involved in a local mikveh organization or initiative ($54-$180 annually — Suggested amount: $100) I am a graduate of the Seven Steps Mikveh Guide Training Program ($10 discount)* Yes No Membership Information Name of Mikveh* Your Name* First Last Email* Has the address of your mikveh changed in the past year?* Yes No Mikveh Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone* Would you like to change the primary contact person and/or organization representatives for your mikveh at this time?* Yes No Name of Primary Contact Person* Email of Primary Contact Person* Names & emails of representative(s) from your organization (up to 5). You can always add/change representatives later.* Please reference your organization listing on our Member Directory. Do you want to see any changes to your listing? Yes No You can view the member directory here: https://www.mayyimhayyim.org/risingtide/members Please write a short description (up to 300 words) about your mikveh to be displayed on the Rising Tide Network website.* Organization Website* To be included with your organization’s member listing (i.e. your main web page, “About Us” page, press release about your Mikveh initiative, or other landing page.) Please enter your changes here:* How would you describe yourself (check all that apply)?* Former Mikveh Guide Current Mikveh Guide Future Mikveh Guide Other (please describe) Please describe:* Please provide a short bio to introduce yourself to the Rising Tide Network.* Payment Add $150 for 5 Mikveh Guide Memberships ($120 discount)* Yes, add 5 Mikveh Guide Memberships No Mikveh Guide Membership offers ongoing learning, support, and connection for Mikveh Guides in your organization. Name and emails of Mikveh Guides - If you don’t know yet, you can provide this information later! Add Access: Mikveh Starter Toolkit Program* Please enter a number from 300 to 500. Sliding scale of $300 – $500 (Suggested: $400) | The Mikveh Starter Toolkit is a robust collection of resources, guided activities, one-on-one consultation, and templates to support communities in launching a new open mikveh initiative. Learn more about the Mikveh Starter Toolkit here. Select Contribution: Mikveh Supporter Membership* Please enter a number from 54 to 180. Sliding scale of $54 – $180 (Suggested: $100) Select Contribution: Mikveh Guide Membership (New Membership)* Please enter a number from 54 to 180. Sliding scale of $54 – $180 (Suggested: $100) Select Contribution: Mikveh Guide Membership (Renewal)* Please enter a number from 54 to 180. Sliding scale of $54 – $180 (Suggested: $100) Select Contribution: Mikveh Guide Membership (Discounted)* Please enter a number from 44 to 170. Sliding scale of $44 – $170 (Suggested: $90) Membership Amount Selected Price: $0.00 Payment Method* Pay securely now with a credit card Please send me an invoice with payment options Organizational Totals For Calc Open Field Totals For Calc Convenience Fee Please add a fully tax-deductible convenience fee of 3% to my donation Convenience Fee Total Price: $0.00 Total $0.00 Credit Card American Express Discover MasterCard Visa Supported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Expiration Date Security Code Cardholder Name CAPTCHA
