Membership Application

Title

Member 1 - First Name

Member 1 - Last Name

Hebrew Name (Would you like one?)

Member 1 - Gender

Marital Status

First name you wish to be addressed by if different from above

Date of Birth

Place of Birth

Street Address

City

State

Zip Code

Cell Phone

Home Phone

Work Phone

Occupation

* Do you have a secondary address (Seasonal home, Mailing address if different from above)?

Please Select OneNoYes

Secondary Address

City

State

Zip Code

Do you use Social Media?

Which social media accounts do you have?

Were you born Jewish?

If No, have you converted or are in the process of converting to Judaism?

* Do you have another adult to add to your Member Account?

Please Select OneYesNo

Member 2 - Gender

Title

Marital Status

Member 2 - First Name

Member 2 - Last Name

First name you wish to be addressed by if different from above

Hebrew Name (Would you like one?)

Secondary Address

City

State

Zip Code

Cell Phone

Home Phone

Work Phone

Occupation

Date of Birth

Place of Birth

Do you use Social Media?

Which social media accounts do you have?

Were you born Jewish?

If No, have you converted or are in the process of converting to Judaism?

Emergency Contact 1 - Name

Relationship

Phone Number

Emergency Contact 2 -Name

Relationship

Phone Number

Are you adding any children to your account?

YesNo

Please enter the name and info of a parent if he/she is not part of the membership unit

Relationship

Best Contact Number

Number of children to add to your member account

Child 1 - First Name

Last Name (if different)

Gender

Hebrew Name (Does child need one?)

Address (if not living with you)

Date of Birth

Grade

Is this child being raised in the Jewish faith only?

When will your child be a student in our Religious school or Hebrew High School?

Is there any additional information about your child you would like to share with us?

Child 2 - First Name

Last Name (if different)

Gender

Hebrew Name (Does child need one?)

Address (if not living with you)

Date of Birth

Grade

Is this child being raised in the Jewish faith only?

When will your child be a student in our Religious school or Hebrew High School?

Is there any additional information about your child you would like to share with us?

Child 3 - First Name

Last Name (if different)

Gender

Hebrew Name (Does child need one?)

Address (if not living with you)

Date of Birth

Grade

Is this child being raised in the Jewish faith only?

When will your child be a student in our Religious school or Hebrew High School?

Is there any additional information about your child you would like to share with us?

Yahrzeits - The names will be recited during the Kaddish prayer (the prayer for the dead) as a token of loving remembrance at the Shabbat service on Friday evening and Saturday morning prior to their Yahrzeit date. Would you like to observe the Secular or Hebrew Date?

Yahrzeit 1 - First Name

Last Name

Date of Death

Before or After Sundown

Relationship to

Yahrzeit 2 - First Name

Last Name

Date of Death

Before or After Sundown

Relationship to

Yahrzeit 3 - First Name

Last Name

Date of Death

Before or After Sundown

Relationship to

Opportunity for Participation and to get to know you better

Please indicate which of these areas interest you or a member of your family by checking the appropriate box or boxes. You will be contacted to learn more about these opportunities by fellow members of our community who share these interests.

Other special skills you would like to share with us?

Please list any family or friends who are already members of Temple Israel

To what organizations or community groups do you belong?

Is there anything else you would like us to know about you and your family? Special needs, immigration, family connection in the Holocaust, Aliyah, etc.

Why did you decide to join Temple Israel?

We are delighted to have you in our sacred community at Temple Israel!

Join Our Mailing List

Follow Us On Social Media