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

* State

* 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

* State

* 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

Before sunsetAfter sunset

(2) Name of deceased

(2) Relationship

(2) To whom

(2) Date of death

(2) Time of death

Before sunsetHebrew Date

(3) Name of deceased

(3) Relationship

(3) To whom

(3) Date of death

(3) Time of death

Before sunsetAfter sunset

(4) Name of deceased

(4) Relationship

(4) To whom

(4) Date of death

(4) Time of death

Before sunsetAfter sunset

(5) Name of deceased

(5) Relationship

(5) To whom

(5) Date of death

(5) Time of death

Before sunsetAfter sunset

(6) Name of deceased

(6) Relationship

(6) To whom

(6) Date of death

(6) Time of death

Before sunsetAfter sunset

* 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 pledge within our guidelines. We do not have a traditional dues model but ask members to make a supporting pledge each year. Please know there are no other dues, High Holiday donations or asks throughout the year, other than for programming or special events. Please also know that our Sustaining Pledge amount (the amount at which if all members paid this we would balance our budget!) for this year is $3,900. You will be contacted by a member of the Executive Team once your Membership Application is approved by the Rabbi and Membership Vice-President. We look forward to having you be a part of our wonderful community.