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Membership


Welcome to Kehillat Beth Israel. Your privacy is important to us. The information you provide will enrich your experience as a member of Kehillat Beth Israel and is for office use only. Please complete this application form by July 15th along with your annual dues payment information. Thank you for becoming a part of our community. We look forward to growing and learning with you and your family.


ADULT 1

e.g. Yaakov ben Yitzhak v'Rikva
Please check all that apply.

Membership in Mercaz increases the voice of the Conservative movement in Israel and as part of the World Zionist Organization. For more information click here.

Masorti is the Conservative movement in Israel. For more information on how Masorti supports the advancement of Conservative Jewish life in Israel
click here.


PARENTS OF ADULT 1


ADULT 2

e.g. Dinah bat Yaakov v'Leah
Please check all that apply.

Membership in Mercaz increases the voice of the Conservative movement in Israel and as part of the World Zionist Organization. For more information click here.

Masorti is the Conservative movement in Israel. For more information on how Masorti supports the advancement of Conservative Jewish life in Israel
click here.


PARENTS OF ADULT 2


YAHRZEIT REMINDERS

Yahrzeit Reminders for Member 1

i.e. English Name, Hebrew Name, Date of Death, Time of Death (if known), Relationship.


Yahrzeit Reminders for Member 2

i.e. English Name, Hebrew Name, Date of Death, Time of Death (if known), Relationship.


ADDRESS & HOME PHONE


EMERGENCY CONTACT INFORMATION


MARITAL STATUS

If applicable.


CHILD 1

optional
optional


CHILD 2

optional
optional


CHILD 3

optional
optional


CHILD 4

optional
optional


CHILD 5

optional
optional


OTHER INFORMATION (IF APPLICABLE)


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, 2019 to June 30, 2020.
I/we understand that all requests for Dues reductions can only be considered after consultation with the Executive Director.


YOUR TOTAL AMOUNT DUE

Fri, 3 February 2023 12 Shevat 5783