Membership Application

Information for Adult #1

Salutation

Mr.Mrs.Ms.Dr.

* First Name

Middle Name

* Last Name

Hebrew Name

* Home Address

* City

* State

* Zip Code

* Mobile Phone

Home/Landline Phone

* Preferred Email Address

Birthdate

Marital Status

If Married, Date of Marriage

Other Religious Affiliation (if applicable)

Did your Jewish Education include (check all that apply)

Bar/Bat MitzvahConfirmationPost-Confirmation Religious School

Previous Synagogue Affiliation (if applicable)

Veteran?

NoYes

Branch

Parent's Information

Parent 1

Parent 2

Yahrzeits Observed

First Name

Last Name

Date of Death

Relationship

Observed

EnglishHebrew

First Name

Last Name

Date of Death

Relationship

Observed

EnglishHebrew

First Name

Last Name

Date of Death

Relationship

Observed

EnglishHebrew

Information for Adult #2

Salutation

Mr.Mrs.Ms.Dr.

First Name

Middle Name

Last Name

Hebrew Name

Home Address

City

State

Zip Code

Mobile Phone

Home/Landline Phone

Preferred Email

Birthdate

Marital Status

If Married, Date of Marriage

Other Religious Affiliation (if applicable)

Did your Jewish Education include (check all that apply)

Bar/Bat MitzvahConfirmationPost-Confirmation Religious School

Previous Synagogue Affiliation (if applicable)

e-mail address

Veteran?

NoYes

Branch

Parent's Information

Parent 1

Parent 2

Yahrzeits Observed

First Name

Last Name

Date of Death

Relationship

Observed

EnglishHebrew

First Name

Last Name

Date of Death

Relationship

Observed

EnglishHebrew

First Name

Last Name

Date of Death

Relationship

Observed

EnglishHebrew

Children's Information

First Name

Middle Name

Last Name

Birthdate

Sex

First Name

Middle Name

Last Name

Birthdate

Sex

First Name

Middle Name

Last Name

Birthdate

Sex

Membership Commitment & Enrollment Information

For Membership categories, please refer to the Membership Rates/Dues Categories schedule included with your packet or available on our Membership page.
The Annual Membership Commitment contribution is payable yearly or in monthly/quarterly installments.
Fiscal year Membership Commitments are billed on a yearly basis in July. The annual membership commitment will be pro-rated if joining within the fiscal year.
Everyone is welcome at our Temple. If you have concerns about your ability to pay, we encourage you to speak confidentially with our Administrator. Any request for a reduced membership rate must be discussed with the Membership Chairperson for approval.

Financial Information

Indicate which membership category is applicable to you:

Total Membership Commitment

Please select the applicable payment method:

I will mail a check to the Temple. I understand that my application will be held in tentative status until payment is received.I would like to pay by credit card. Please call me at the number provided in my application.

I/We want to become a member of Temple Beth-El, and will make a personal & financial commitment to the support & continuation of this community. I/we are able to support the Temple at the financial level chosen.

Please sign electronically below:

* Person #1-Please sign electronically (Full Name) here:

Person #2-Please sign electronically (Full Name) here:

Contact Info

Shabbat Times

This week's Torah portion is Parashat Chayei Sarah

Candle Lighting

Havdalah