2022 New Member Application Form

Please note: All applications for membership are subject to approval by the Temple Israel Board of Trustees. Applications are approved at monthly Board meetings so long as the requirements established in the Temple Israel bylaws are met by the applicant.

Address Information

* Address

* City

* State

* Zip Code

Home Phone

Adult 1 Information

* First Name

Middle Name

* Last Name

* Email

* Primary Phone

* Birthdate

Place of Birth

Hebrew Name

Father's Hebrew Name

Mother's Hebrew Name

* Religious Affiliation

Other

Occupation

Employer

Work Phone

* Marital Status

Anniversary Date (if applicable)

* Is there a second Adult applying for Membership?

Adult 2 Information

* First Name

Middle Name

* Last Name

Preferred Name

* Email

* Primary Phone

* Birthdate

Place of Birth

Hebrew Name

Father's Hebrew Name

Mother's Hebrew Name

* Religious Affiliation

Other

Occupation

Employer

* How many children live in your home?

Child 1

* Child 1 - First Name

* Child 1 - Middle Name

* Child 1 - Last Name

Child 1 - Preferred Name

Child 1 - Hebrew Name

* Child 1 - Birthdate

* Child 1 - Name of Current School

* Child 1 - Grade

* Child 1 - Is the child being raised Jewish?

* Child 1 - Will this child be attending Religious School at Temple Israel?*

*Tuition
*Tuition
*Tuition

Child 1 - If previosuly attended Religious School, list Congregation and City

Child 1 - Bar/Bat Mitzvah Date

Child 1 - Bar/Bat Mitzvah Congregation

Child 1 - Bar/Bat Mitzvah City

Child 2

* Child 2 - First Name

* Child 2 - Middle Name

* Child 2 - Last Name

Child 2 - Preferred Name

Child 2 - Hebrew Name

* Child 2 - Birthdate

* Child 2 - Name of Current School

* Child 2 - Grade

* Child 2 - Is the child being raised Jewish?

* Child 2 - Will this child be attending Religious School at Temple Israel?

Child 2 - If previosuly attended Religious School, list Congregation and City

Child 2 - Bar/Bat Mitzvah Date

Child 2 - Bar/Bat Mitzvah Congregation

Child 2 - Bar/Bat Mitzvah City

Child 3

* Child 3 - First Name

* Child 3 - Middle Name

* Child 3 - Last Name

Child 3 - Preferred Name

Child 3 - Hebrew Name

* Child 3 - Birthdate

* Child 3 - Name of Current School

* Child 3 - Grade

* Child 3 - Is the child being raised Jewish?

* Child 3 - Will this child be attending Religious School at Temple Israel?

Child 3 - If previosuly attended Religious School, list Congregation and City

Child 3 - Bar/Bat Mitzvah Date

Child 3 - Bar/Bat Mitzvah Congregation

Child 3 - Bar/Bat Mitzvah City

Child 4

* Child 4 - First Name

* Child 4 - Middle Name

* Child 4 - Last Name

Child 4 - Preferred Name

Child 4 - Hebrew Name

* Child 4 - Birthdate

* Child 4 - Name of Current School

* Child 4 - Grade

* Child 4 - Is the child being raised Jewish?

* Child 4 - Will this child be attending Religious School at Temple Israel?

Child 4 - If previosuly attended Religious School, list Congregation and City

Child 4 - Bar/Bat Mitzvah Date

Child 4 - Bar/Bat Mitzvah Congregation

Child 4 - Bar/Bat Mitzvah City

Joining Our Community

* Please indicate your membership category. All categories automatically include CNAF ($75) and Security ($75) assessments.

Our relationship with you is a covenant. The only way for us to fulfill our commitment to you is for you to contribute to the success of our community.

* Please describe your financial situation or reasons for dues relief.

Upon submission of this form, you will receive an email from Temple Israel staff with the instructions to fill out the required dues relief form.

I/We would like to learn more about how I/We can leave a lasting legacy to Temple Israel. Please contact me.

If you would consider adding an additional amount to your covenant for the good and welfare for Temple Israel, this would be greatly appreciated. We expect some members to have financial challenges during the coming year and this will have an impact on the community's overall finances.

Please enter the additional contribution amount in the box above.

Total

Please click the submit button below to proceed to our payment page and arrange your dues covenant.

Mon, October 3 2022 8 Tishrei 5783