Associate Renewal 20/21

Welcome to Kehillat Beth Israel. Your privacy is important to us. The information you provide will enrich your experience as an associate of Kehillat Beth Israel and is for office use only. Please complete this form by August 15th along with your annual dues payment information. Thank you for being a part of our community; we look forward to continuing to grow and learn with you and your family.

If you are paying by cheque, please click here to download our Associate application form.

ADULT 1

* First Name

* Last Name

Hebrew Name

e.g. Yaakov ben Yitzhak v'Rikva

Tribe

* Mobile Phone

* Email Address

Please check all that apply:

I would like to renew as an associate - $250/personI would like to receive the weekly newsletterI would like to volunteer

Are you affiliated with another synagogue?

YesNo

If yes, please provide name/city/province of synagogue:

Total Due

ADULT 2

First Name

Last Name

Hebrew Name

e.g. Dinah bat Yaakov v'Leah

Tribe

Mobile Phone

Email Address

Please check all that apply:

I would like to renew as an associate - $250/personI would like to receive the weekly newsletterI would like to volunteer

Are you affiliated with another synagogue?

YesNo

If yes, please provide name/city/province of synagogue:

Total Due

ADDRESS & HOME PHONE

* Address Line 1

Address Line 2

* City

* Province

* Postal Code

Phone Number

EMERGENCY CONTACT INFORMATION

Name of emergency contact

Phone number of emergency contact

Relationship to family

MEMBERSHIP AGREEMENT

I/we promise to abide by all the rules and regulations of the Congregation as stated in the By-Laws.

I/we understand that the Fiscal Year for payment of all Kehillat Beth Israel accounts is July 1, 2020 to June 30, 2021.

I/we agree with all of the above statements.

YOUR TOTAL AMOUNT DUE

Total Due

ADULT 1

ADULT 2

ADDRESS & HOME PHONE

EMERGENCY CONTACT INFORMATION

MEMBERSHIP AGREEMENT

I/we promise to abide by all the rules and regulations of the Congregation as stated in the By-Laws.

I/we understand that the Fiscal Year for payment of all Kehillat Beth Israel accounts is July 1, 2020 to June 30, 2021.

YOUR TOTAL AMOUNT DUE

Friday Night

Shabbat Day

This week's Torah portion is Parshat Beshalach

Candle Lighting

Havdalah

Tu B'Shvat