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New Member Form 2022-2023
Please verify reCaptcha before submitting the form.
Welcome Home
Temple Beth El is a vibrant and inclusive Reform Jewish community that values warm welcome, meaningful relationships, and inspirational personal growth. We are a congregation where learning, prayer, and deeds help to transform people’s understanding of themselves, channel the power of community, and inform our responsibilities to the world.
We do this in a sacred community where we learn together, we pray together, we act together, we play together, we care for each other, and we are accountable to each other.
Date
Type of membership requested
Individual
Family
Please Select One
I am a new Temple Beth El member
I am a returning Temple Beth El member
Mailing Name & Address
*
First Name
*
Last Name
*
Primary Email Address
*
Primary Cell Phone
*
Primary Address
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
Primary Email Address - Member #2
Primary Phone Number - Member #2
*
Marital Status
Please Select One
Married
Single
Committed Relationship
Engaged
Anniversary Date
Intended Wedding Date
Adult Member
First Name
Last Name
Name you like to be called
Hebrew Name (if applicable)
Date of Birth
Occupation
Business Name
Title
Business Phone
Retired
Retired
Religious Affiliation
Previous Temple Affiliation
City & State
Emergency Contact (not living with you)
Previous Congregational Involvement. Please check all that apply:
Board Member
Board Member
Title
Religious School Teacher
Religious School Teacher
Grade
Committee/Groups/Volunteer
Committee/Groups/Volunteer
Adult Member #2
First Name
Last Name
Name you like to be called
Hebrew Name (if applicable)
Date of Birth
Occupation
Business Name
Title
Business Phone
Retired
Retired
Religious Affiliation
Previous Temple Affiliation
City & State
Previous Congregational Involvement. Please check all that apply.
Board Member
Board Member
Title
Religious School Teacher
Religious School Teacher
Grade
Committee/Groups/Volunteer
Committee/Groups/Volunteer
Emergency Contact (not living with you)
Please click the + to add additional adult members
First Name
Last Name
Name you like to be called
Hebrew Name (if applicable)
Date of Birth
Occupation
Business Name
Title
Business Phone
Retired
Retired
Religious Affiliation
Previous Temple Affiliation
City
State
Previous Congregational Involvement. Please check all that apply
Board Member
Board Member
Title
Religious School Teacher
Religious School Teacher
Grade
Committee/Groups/Volunteer
Committee/Groups/Volunteer
Please name those you were involved with
Emergency Contact (not living with you)
Is there anything additional that you would like for us to know about you and your family
Is there anything additional that you would like for us to know about you and your family?
Children
Please include grown children as well as those living at home
First Name
Last Name
Hebrew Name (if applicable)
Gender
Date of Birth
Grade in Secular School
Grade in Religious School
College
New Members Requesting a Bar/Bat Mitzvah Date
(apples only to 4th/5th graders and above, depending in birth date)
How many years has your child attended religious school?
0
1
2
3
4
5
6
7
8
9
10
How many years included Hebrew?
0
1
2
3
4
5
6
7
8
9
10
Did your child have a bar/bat mitzvah date elsewhere? If so, what was it?
Does your child have any special needs or learning challenges that we should know about?
Click the + to add children
First Name
Last Name
Hebrew Name (if applicable)
Gender
Date of Birth
Grade in Secular School
Grade in Religious School
College
Yahrzeits are observed and announced at the religious service during the week of the date of death. Please list names of those
immediate
family members (parents, grandparents, children, and siblings) you wish remembered. Please indicate which date you prefer to observe.
Please Select One
I prefer to observe the English date
I prefer to observe the Hebrew date
First Name
Last Name
State the nature of relationship to Adult #1 and/or Adult #2
English date of death
Hebrew date of death
Click the + to add additional Yahrzeits
Please Select One
I prefer to observe the English date
I prefer to observe the Hebrew date
First Name
Last Name
State the nature of relationship to Adult #1 and/or Adult #2
English date of death
Hebrew date of death
I can afford the base commitment
I cannot afford the base commitment and need a Commitment Review Form
You can find our Commitment Review Form
here
. Please fill out the Commitment Review Form in addition to the New Member Form for your membership to be processed.
Please contact
Eden Gobuty, Director of Development and Member Services
with any questions or concerns.
My Temple Commitment
My Temple Commitment (Please choose your appropriate level from above)
Please Select One
Family - Base Commitment
Family - 34-36 Years old
Family - 30-33 Years old
Family - 26-29 years old
Family - 25 & younger
Individual - Base Commitment
Individual - 34-36 years old
Individual 30 - 33 years old
individual 26-29 years old
Individual 25 years old & younger
I would like to give above Base Commitment but below Sustainer Levels
Sustainers
Sustainer Level Commitment
*
Security Fee of $144
Security Fee of $144
Would you like to supplement your security fee with an additional donation? Please enter the additional amount here.
Total Commitment
Choose your number of payments
Please Select One
Single Payment
Two Payments
6 monthly payments (provided payment begins January 2023)
Choose your method of payment
Please Select One
Check
ACH Debit
Credit Card
I Want To:
Learn (Adult Education)
Connect & Engage (Brotherhood, Porch, Small Groups, and SPICE)
Schedule Clergy for Lifecycles (Baby Namings, Wedding, Conversion, B'nei Mitzvah, and Funerals)
Learn more about Judaism
Find Jewish Opportunities for my Child(ren)
Repair the World (Justice and Action)
Care for Others (Hineynu)
Is there anything else you are interested in?
If applicable, please share the name of who referred you to Temple Beth El so that we may thank them.
Signature Required
As a member of Temple Beth El, I understand that I am making a commitment to sustain this congregation and to ensure a bright future for our children and generations to come. I further understand that the Temple depends on this My Temple Commitment, and I pledge to fulfill my financial obligation on or before June 30, 2023.
*
Signature
Initials Requested
I give Temple Beth El permission to continue charging my account or credit card annually using the method and timing indicated above. The amount may increase each year at a maximum of 4% (in alignment with MTC increases) without additional permission. I will notify TBE if I wish to stop automatic payments on my account.
Signature
I give permission for auto-renewal
Wed, March 29 2023
7 Nisan 5783
Wed, March 29 2023 7 Nisan 5783