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Temple Israel Membership Application
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Shalom and welcome!
We are delighted by your interest in our synagogue. Temple Israel is a warm and friendly traditional egalitarian synagogue. We celebrate together in good times and support each other during life's difficult moments. Founded over 70 years ago, you will find many members from among original families. We are teachers, at-home parents, doctors, business owners, actively employed and actively enjoying retirement.
At Temple Israel we strive to foster growth of each of our members, to help each person find meaning and fulfillment in the practice of Conservative Judaism. We are vibrant congregation of learners, a community actively involved in caring for each other, and a synagogue dedicated to daily, Shabbat and holiday prayer, and most importantly, passing the traditions of Judaism on to the next generation.
We look forward to the merging of your family and ours.
Family Name
Date of Application
Name of Congregation
Mailing Address
City
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Adult 1 -Title
Adult 1 - First Name
Adult 1 - Middle Name
Adult 1 - Last Name
Adult 1 - Preferred Name
*
Primary Address Line 1
Primary Address Line 2
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
Adult 1 - Email
Adult 1 - Mobile Phone
Adult 1 - Date of Birth
Adult 1 - Tribe
Cohen
Levi
Yisrael
None Set
Adult 1 - Hebrew Name
Please use English transliteration
Adult 1 - Father's Hebrew Name
Please use English transliteration
Adult 1 - Mother's Hebrew Name
Please use English transliteration
Adult 1 - Occupation
Or Retired
Adult 1 - Job Title
Adult 1 - Employer
Adult 1 - Employer Address
Adult 1 - Employer City
Adult 1 - Employer State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Adult 1 - Employer Zip Code
Adult 1 - Please list your areas of interest
Adult Text Learning
Brotherhood**
Bulletin/PR
Cultural Arts
Development
Planning Family-Centered Events
** All new members receive one year complimentary membership in the Brotherhood and Sisterhood.
Hessed/Caring Community
Hazak (55+)
Holocaust Memorial
House Committee
Israel Affairs
PTO
Sisterhood**
Social Action
Torah Reading
Development
Youth Activities
Is there a second adult applying for Membership?
Please Select One
Yes
No
Adult 2 - Title
Adult 2 - First Name
Adult 2 - Middle Name
Adult 2 - Last Name
Adult 2 - Preferred Name
Adult 2 - Email
Adult 2 - Mobile
Adult 2 - Date of Birth
Adult 2 - Tribe
Adult 2 - Hebrew Name
Please use English transliteration
Adult 2 - Father's Hebrew Name
Please use English transliteration
Adult 2 - Mother's Hebrew Name
Please use English transliteration
Adult 2 - Occupation
Or Retired
Adult 2 -Job Title
Adult 2 - Employer
Adult 2 - Employer Address
Adult 2 - Employer City
Adult 2 - Employer State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Adult 2 - Employer Zip Code
Adult 2 - Please list your areas of interest
Adult Text Learning
Brotherhood**
Bulletin/PR
Cultural Arts
Development
Planning Family-Centered Events
** All new members receive one year complimentary membership in the Brotherhood and Sisterhood.
Hessed/Caring Community
Hazak (55+)
Holocaust Memorial
House Committee
Israel Affairs
PTO
Sisterhood**
Social Action
Torah Reading
Development
Youth Activities
How many children live in the family home?
Please Select One
None
One child
Two Children
Three Children
Four Children
Child 1 - Last Name
Child 1 - First Name
Child 1 - Gender Pronoun
N/A or Unknown
Male
Female
Child 1 - Date of Birth
Child 1 - Any Special Needs
Child 1 - If bar/bat mitzvah, what year celebrated?
Child 1 - Hebrew Name
Transliterated in English
Child 1 - Grade in School
Child 1- Is child enrolled in Prozdor?
Child 1 - Name of Secular School
Child 1 - College Address (If applicable)
Child 2 - Last Name
Child 2 - First Name
Child 2 - Gender Pronoun
N/A or Unknown
Male
Female
Child 2 - Date of Birth
Child 2 - Any Special Needs
Child 2 - If bar/bat mitzvah, what year celebrated?
Child 2 - Hebrew Name
Transliterated in English
Child 2 - Grade in School
Child 2 - Is child enrolled in Prozdor?
Child 2 - Name of Secular School
Child 2 - College Address (If applicable)
Child 3 - Last Name
Child 3 - First Name
Child 3 - Gender Pronoun
N/A or Unknown
Male
Female
Child 3 - Date of Birth
Child 3 - Any Special Needs
Child 3 - College Address (If applicable)
Child 3 - Hebrew Name
Transliterated in English
Child 3 - Grade in School
Child 3 - Is child enrolled in Prozdor?
Child 3 - Name of Secular School
Child 3 - College Address (If applicable)
Child 4 - Last Name
Child 4 - First Name
Child 4 - Gender Pronoun
N/A or Unknown
Male
Female
Child 4 - Date of Birth
Child 4 - Any Special Needs
Child 4 - If bar/bat mitzvah, what year celebrated?
Child 4 - Hebrew Name
Transliterated in English
Child 4 - Grade in school
Child 4 - Is child enrolled in Prozdor?
Child 4 - Name of Secular School
Child 4 - College Address (If applicable)
Jewish custom calls for observing the anniversary of death of loved ones according to the Jewish calendar. Please complete the information below, if pertinent, so that we may in form you of the Yahrzeit Date.
How many name would you like to add to our Yahrzeit list?
Please Select One
None
One
Two
Three
Four
Related to:
Please Select One
Adult 1
Adult 2
Relationship of Deceased to Adult
Deceased English Name
Deceased Hebrew Name
Secular Date of Death
Before/After Sundown
Please Select One
Before
After
Related to:
Please Select One
Adult 1
Adult 2
Relationship of Deceased to Adult
Deceased English Name
Deceased Hebrew Name
Secular Date of Death
Before/After Sundown
Please Select One
Before
After
Related to:
Please Select One
Adult 1
Adult 2
Relationship of Deceased to Adult
Deceased English Name
Deceased Hebrew Name
Secular Date of Death
Before/After Sundown
Please Select One
Before
After
Related to:
Please Select One
Adult 1
Adult 2
Relationship of Deceased to Adult
Deceased English Name
Deceased Hebrew Name
Secular Date of Death
Before/After Sundown
Please Select One
Before
After
*
I/We hereby apply for membership in the congregation of Temple Israel. I/We will abide by all its rules and regulations and shall support its religious , educational, and cultural activities.
I/We hereby apply for membership in the congregation of Temple Israel. I/We will abide by all its rules and regulations and shall support its religious , educational, and cultural activities.
*
Applicant Initials
*
Date
I/We commit to pay the sum below by May 31st of this year. Religious school tuitions/fees, adult class fees, additional High Holyday seats, simcha fees, etc., are to be charged and paid separately from the Annual Commitment indicated below. Thereafter, we agree to pay an Annual Commitment and any special assessments as may be fixed by the Board of trustees in accordance with the By-Laws of Temple Israel.
please enter $ amount above
*
Applicant Initials
*
Date
*
I/We commit to pay the sum of $2,400 to the Temple Israel Building Fund at a rate of $400 per year with the yearly payment due and payable not later than May 31st of each year. The Building Fund is intended to help with the ongoing maintenance of the physical plant which our earlier members helped to build. Thus all members share in providing the home for our congregation.
I/We commit to pay the sum of $2,400 to the Temple Israel Building Fund at a rate of $400 per year with the yearly payment due and payable not later than May 31st of each year. The Building Fund is intended to help with the ongoing maintenance of the physical plant which our earlier members helped to build. Thus all members share in providing the home for our congregation.
*
Applicant Initials
*
Date
If you cancel your membership, in writing to the Temple office, you and/or your family will be responsible for the yearly amount of your Building Fund assessment from the date of joining until the time your cancellation becomes effective, as well as any unpaid Annual Commitments, special assessments, fees and costs associated with the Religious School.
Mon, January 27 2025 27 Tevet 5785