Membership Application - Form - Congregation B'nai Israel

* Member 1: First name

* Member 1: Last name

* Member 1: Date of birth

* Member 1: Place of birth

* Member 1: Marital status

* Date of marriage (if applicable)

* Member 1: Email address

* Member 1: Cell phone

* Member 1: Occupation/Title

* Member 1: Employer

* Member 1: Work phone

* Member 1: Religion

* Member 1: Religious affiliation

* Member 1: Jewish

Please Select OneBy birthBy choice

Member 1: Date and place of conversion

* Member 1: Hebrew name

Please include your name, your father's name & your mother's name
Example: Isaac ben Abraham v'Sarah (ben = son of, bat = daughter of; v = and)

* Member 1: Bar/Bat Mitzvah date

* Member 1: Can you read Hebrew and/or chant Torah?

Read HebrewChant Torah

* Member 1: Do you have relatives at Congregation B'nai Israel? If yes, please list names and relationship.

We welcome our members to become involved in Temple life and activities.
Please check any activities that interest you. We will be in touch!

* Member 1: If other, please specify:

* Address

* City

* Province

* Postal Code

* Home phone number

* Is there a second Adult applying for membership?

* Member 2: First name

* Member 2: Last name

* Member 2: Date of birth

* Member 2: Place of birth

* Member 2: Marital status

* Member 2: Email address

* Member 2: Cell phone

* Member 2: Occupation/Title

* Member 2: Employer

* Member 2: Work phone

* Member 2: Religion

* Member 2: Religious affiliation

* Member 2: Jewish

Please Select OneBy birthBy choice

Member 2: Date and place of conversion

* Member 2: Hebrew name

Please include your name, your father's name & your mother's name
Example: Isaac ben Abraham v'Sarah (ben = son of, bat = daughter of; v = and)

* Member 2: Bar/Bat Mitzvah date

* Member 2: Can you read Hebrew and/or chant Torah?

Read HebrewChant Torah

* Member 2: Do you have relatives at Congregation B'nai Israel? If yes, please list names and relationship.

We welcome our members to become involved in Temple life and activities.
Please check any activities that interest you. We will be in touch!

* Member 2: If other, please specify:

* Does Member 2 live at the same address as Member 1?

* Address

* City

* Province

* Postal Code

* Number of children:

* Applies to each of your children who reside with you.

* Child 1: First name

* Child 1: Last name

* Child 1: Birth date

* Child 1: Gender

* Child 1: School grade fall 2021

* Child 1: School Name

* Child 1: Hebrew name

* Child 2: First name

* Child 2: Last name

* Child 2: Birth date

* Child 2: Gender

* Child 2: School grade fall 2021

* Child 2: School Name

* Child 2: Hebrew name

* Child 3: First name

* Child 3: Last name

* Child 3: Birth date

* Child 3: Gender

* Child 3: School grade fall 2021

* Child 3: School Name

* Child 3: Hebrew name

* Child 4: First name

* Child 4: Last name

* Child 4: Birth date

* Child 4: Gender

* Child 4: School grade fall 2021

* Child 4: School Name

* Child 4: Hebrew name

* Please list all Adult children who do NOT reside with you

* Please enter the number of people for whom you wish to observe yahrtzeit (memorial)

* A Yahrzeit reminder notice will be sent to you every year.

Please list the names of loved ones for whom you wish Yahrzeit notices sent

* (1) Name of deceased

* (1) Relationship

* (1) To whom

* (1) Date of death

* (1) Time of death

Please Select OneBefore sunsetAfter sunset

* (1) I'd like to observe the

Please Select OneGregorian DateHebrew Date

* (2) Name of deceased

* (2) Relationship

* (2) To whom

* (2) Date of death

* (2) Time of death

Please Select OneBefore sunsetHebrew Date

* (2) I'd like to observe the

Please Select OneGregorian DateHebrew Date

* (3) Name of deceased

* (3) Relationship

* (3) To whom

* (3) Date of death

* (3) Time of death

Please Select OneBefore sunsetAfter sunset

* (3) I'd like to observe the

Please Select OneGregorian DateHebrew Date

* (4) Name of deceased

* (4) Relationship

* (4) To whom

* (4) Date of death

* (4) Time of death

Please Select OneBefore sunsetAfter sunset

* (4) I'd like to observe the

Please Select OneGregorian DateHebrew Date

* (5) Name of deceased

* (5) Relationship

* (5) To whom

* (5) Date of death

* (5) Time of death

Please Select OneBefore sunsetAfter sunset

* (5) I'd like to observe the

Please Select OneGregorian DateHebrew Date

* (6) Name of deceased

* (6) Relationship

* (6) To whom

* (6) Date of death

* (6) Time of death

Please Select OneBefore sunsetAfter sunset

* (6) I'd like to observe the

Please Select OneGregorian DateHebrew Date

* How did you hear about Congregation B'nai Israel?

* Reason(s) for joining our synagogue:

Congregation B'nai Israel (CBI) is open to any Jew regardless of income. Our ability to welcome all Jews who wish to worship with us depends on the generosity of our congregants. To ensure that this tradition continues, we ask that you be thoughtful about your financial ability to contribute and remember that you state your pledge within our guidelines and there are no other dues, High Holiday donations or asks throughout the year, other than programming or special events. Be part of the community and give until it feels good.

* Please choose a Membership Pledge for 2021-2022

Please Note:
In recognition of their financial leadership, there will be acknowledgement in the Kolenu of all pledges at the Sustaining Pledge level and above unless anonymity is requested.
Pillars shall participate in all programs/functions and meals at no additional charge.
All pledges will be reviewed by the Supporting Pledge Financial Committee prior to acceptance.
An acknowledgement of each pledge will be sent.
High Holiday Tickets included in membership
To receive High Holiday Tickets, all past balances must be paid in full, and a minimum of 25% of the current year’s Pledge paid.

* Please enter your $ pledge below:

Total Commitment