Membership Application

ADULT 1 INFORMATION

Title

Please only include if other than Mr/Mrs/Ms

* First Name

Nickname

Middle Name

* Last Name

Gender

Pronouns

* Email Address

Cell

Birthdate

Maiden Name

Hebrew Name

Tribe at Birth

Father Hebrew Name

Mother Hebrew Name

Business Name

Occupation

Business Phone

Special Skills or Areas of Expertise

ADULT 2 INFORMATION (IF NEEDED)

Title

Please only include if other than Mr/Mrs/Ms

First Name

Nickname

Middle Name

Last Name

Gender

Pronouns

Email Address

Cell

Birthdate

Maiden Name

Hebrew Name

Tribe at Birth

Father Hebrew Name

Mother Hebrew Name

Business Name

Occupation

Business Phone

Special Skills or Areas of Expertise

HOUSEHOLD INFORMATION

* Home Street Address

* City

* State

* Zip Code

Home Phone Number

Marital Status

Anniversary

CHILDREN

Please click on the + button to add each child.

First Name

Nickname

Middle Name

Last Name

Gender

Pronouns

Birthdate

After Sunset?

Tribe

Hebrew Name

Father Hebrew Name

Mother Hebrew Name

YAHRZEITS

Please click on the + button to add each yahrzeit.

English Name of Deceased

Hebrew Name of Deceased

Gender of Deceased

English Date of Death

After Sunset?

Observe Hebrew or English Date?

Mourner in Family

Relationship to Mourner

Cemetery

Is there anything else you would like to share with us?

FAIR SHARE STATEMENT

In place of a dues requirement, Temple Beth Sholom operates on the basis of Fair Share – the philosophy that makes each of us responsible for the other. It allows those of us who can assume a larger share of the financial burden, based on our own assessment of ability, to do so. The Fair Share commitment of each member, each year, contributes the major portion of Temple income to cover operating expenses. Our Building Fund charge, payable over 5 years, also helps maintain our House of Worship and Religious Schools. High Holiday tickets are allotted based on family composition.

* MEMBERSHIP RENEWAL: By checking this box I indicate that I understand and agree that my membership will automatically be renewed each year unless a notice of termination is received in writing at the synagogue office at least thirty (30) days prior to the renewal year on July 1.

MEMBERSHIP RENEWAL: By checking this box I indicate that I understand and agree that my membership will automatically be renewed each year unless a notice of termination is received in writing at the synagogue office at least thirty (30) days prior to the renewal year on July 1.

Wed, April 24 2024 16 Nisan 5784