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Membership Application
Please verify reCaptcha before submitting the form.
Beth Israel Congregation Membership Application
*
Member A - First Name
Member A - Middle Name
*
Member A - Last Name
*
Member A - Gender
N/A or Unknown
Male
Female
*
Member A - Date of Birth
*
Member A - Email
*
Member A - Mobile Phone
Member A - Home Phone
Member A - Religion
Member A - Hebrew Name
Member A - Mother's Hebrew Name
Member A - Father's Hebrew Name
Member A - Home Address
Member A - City
Member A - 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
Member A - Zip Code
Member A - Profession
Member A - Employer
*
Member A - Marital Status
Single
Married
Engaged
Divorced
Widowed
Separated
N/A
Partnered
At Beth Israel, your involvement will make our community stronger. Get connected, and share your talents and interests. Please select the committees or programs that are of interest to you, and the chair of that committee will contact you.
Adult Education
Communication
Finance
Fundraising
House (Building upkeep)
Keruv (Interfaith families)
Legacy & Endowment
Marketing
Membership
Parents Association (Religious School)
Ritual
School Board
Special Events/Programming
Social Action
Technology
What are the most important aspects of synagogue life for you? Please rate the importance of each of the following: (
NOT
Important,
MODERATELY
Important,
VERY
Important)
Weekly Shabbat Services
Please Select One
Not Important
Moderately Important
Very Important
High Holiday Services
Please Select One
Not Important
Moderately Important
Very Important
Holiday Programs
Please Select One
Not Important
Moderately Important
Very Important
Children's Jewish Education
Please Select One
Not Important
Moderately Important
Very Important
Adult Jewish Education
Please Select One
Not Important
Moderately Important
Very Important
Teen Programs
Please Select One
Not Important
Moderately Important
Very Important
Social Events
Please Select One
Not Important
Moderately Important
Very Important
Events for Families
Please Select One
Not Important
Moderately Important
Very Important
Events for Young People
Please Select One
Not Important
Moderately Important
Very Important
Events for Young Couples
Please Select One
Not Important
Moderately Important
Very Important
Youth Events
Please Select One
Not Important
Moderately Important
Very Important
Sisterhood
Please Select One
Not Important
Moderately Important
Very Important
Brotherhood
Please Select One
Not Important
Moderately Important
Very Important
Programs for Adults and Empty Nesters
Please Select One
Not Important
Moderately Important
Very Important
Online Learning and Worship
Please Select One
Not Important
Moderately Important
Very Important
*
Is there a second adult applying for membership?
Please Select One
Yes
No
*
Member B - First Name
Member B - Middle Name
*
Member B - Last Name
*
Member B - Gender
N/A or Unknown
Male
Female
Member B - Date of Birth
*
Member B - Email
*
Member B - Mobile Phone
Member B - Other Phone
Member B - Religion
Member B - Hebrew Name
Member B - Mother's Hebrew Name
Member B - Father's Hebrew Name
Member B - Home Address
Member B - City
Member B - State
Member B - Zip Code
Member B - Profession
Member B - Employer
At Beth Israel, your involvement will make our community stronger. Get connected, and share your talents and interests. Please select the committees or programs that are of interest to you, and the chair of that committee will contact you.
Adult Education
Communication
Finance
Fundraising
House (Building upkeep)
Keruv (Interfaith families)
Legacy & Endowment
Marketing
Membership
Parents Association (Religious School)
Ritual
School Board
Special Events/Programming
Strategic Planning
Technology
*
How many children live in the family home?
Please Select One
none
One child
Two children
Three children
Four children
*
Child 1 - First Name
*
Child 1 - Last Name
*
Child 1 - Nick Name
*
Child 1 - Child lives with:
Please Select One
Both parents
Member A
Member B
Other
Child 1 - Date of Birth
*
Child 1 - Gender
N/A or Unknown
Male
Female
*
Child 1 - Bar/Bat Mitzvah
Please Select One
Yes
No
Child 1 - Date of Bar/Bat Mitzvah
*
Child 1 - Hebrew Name
*
Child 1 - School Name
*
Child 1 - Grade
*
Child 2 - First Name
*
Child 2 - Last Name
*
Child 2 - Nick Name
*
Child 2 - Child lives with:
Please Select One
Both parents
Member A
Member B
Other
Child 2 - Date of Birth
*
Child 2 - Gender
N/A or Unknown
Male
Female
*
Child 2 - Bar/Bat Mitzvah
Please Select One
Yes
No
Child 2 - Date of Bar/Bat Mitzvah
*
Child 2 - Hebrew Name
*
Child 2 - School Name
*
Child 2 - Grade
*
Child 3 - First Name
*
Child 3 - Last Name
*
Child 3 - Nick Name
*
Child 3 - Child lives with:
Please Select One
Both parents
Member A
Member B
Other
Child 3 - Date of Birth
*
Child 3 - Gender
N/A or Unknown
Male
Female
*
Child 3 - Bar/Bat Mitzvah
Please Select One
Yes
No
Child 3 - Date of Bar/Bat Mitzvah
*
Child 3 - Hebrew Name
*
Child 3 - School Name
*
Child 3 - Grade
*
Child 4 - First Name
*
Child 4 - Last Name
*
Child 4 - Nick Name
*
Child 4 - Child lives with:
Please Select One
Both parents
Member A
Member B
Other
Child 4 - Date of Birth
*
Child 4 - Gender
N/A or Unknown
Male
Female
*
Child 4 - Bar/Bat Mitzvah
Please Select One
Yes
No
Child 4 - Date of Bar/Bat Mitzvah
*
Child 4 - Hebrew Name
*
Child 4 - School Name
*
Child 4 - Grade
How did you learn about Beth Israel?
If you are new to the area, where did you live previously?
Are you currently, or have you been affiliated with another Baltimore area congregation, and if so, which one??
What has led you to join Beth Israel? Please tell us about your Jewish journey.
What has led you to join Beth Israel? Please tell us about your Jewish journey.
It is custom at Beth Israel to read the names of loved ones who are no longer with us on the anniversary of their passing. You will be notified before the date of your loved one's yahrzeit.
*
How many Yahrzeit's would you like to observe?
Please Select One
None
One yahrzeit
Two yahrzeits
Three yahrzeits
Four yahrzeits
Five yahrzeits
Six yahrzeits
Name (English)
Name (Hebrew)
Relationship
Secular Date
Before/After Sunset?
Please Select One
Before Sunset
After Sunset
Name (English)
Name (Hebrew)
Relationship
Secular Date
Before/After Sunset?
Please Select One
Before Sunset
After Sunset
Name (English)
Name (Hebrew)
Relationship
Secular Date
Before/After Sunset?
Please Select One
Before Sunset
After Sunset
Name (English)
Name (Hebrew)
Relationship
Secular Date
Before/After Sunset?
Please Select One
Before Sunset
After Sunset
Name (English)
Name (Hebrew)
Relationship
Secular Date
Before/After Sunset?
Please Select One
Before Sunset
After Sunset
Name (English)
Name (Hebrew)
Relationship
Secular Date
Before/After Sunset?
Please Select One
Before Sunset
After Sunset
I hereby apply for membership in Beth Israel Congregation and promise to abide by all the rules and regulations of the Congregation. I pledge my commitment to the Beth Israel community by sharing my ideas, passions and convictions. I will turn to Bth Israel in times of prayer, celebration and need, and offer my support and commitment to my congregation.
Fri, December 6 2024 5 Kislev 5785
