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Membership form
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Congregation B'nai Israel
Membership form
Family information
*
Street address
*
City
*
State
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Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
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*
Zip code
Home phone (land line)
Family email address (if applicable)
Individual #1
*
First name
*
Last name
Date of birth
*
Cell phone number
*
Email address
*
CBI communicates with emails (e.g., weekly eletter and other important information including funeral notices, special programs, changes due to weather, etc.), phone blasts, and, rarely, regular mail. Please indicate if you wish to receive emails and phone calls and which phone number (home phone and/or cell phone) should be used. (can pick more than one)
Personal email
Family email
Cell phone
Home phone
We have an online membership directory, accessible only for members who log in. You have the option to have your information visible or hidden.
Address
Yes
No, Hide my address from the directory
Phone
Yes
No, Hide my phone from the directory
Show account (all information)
Yes
No, Hide my account (all information) from the directory
*
Marital status
Please Select One
Married
Single
Separated
Divorced
Widowed
*
Is person Jewish?
Please Select One
Yes
No
Please provide details, if needed
If Jewish, Hebrew name. Please include parents' Hebrew names.
*
Occupation (if retired, enter previous career)
Please select
Advertising/writing
Business
Construction
Culinary Arts
Education
Electrician
Engineering
Financial
Framing
Graphic Design
Healthcare/Medical
Insurance
Law
Music
Plumbing
Real Estate
Sales
Social work
Speech
Technology
Name of business
LinkedIn handle
Instagram handle
Facebook handle
Individual #2
First name
Last name
Last name
Date of birth
Cell phone number
Email address
CBI communicates with emails (e.g., weekly eletter and other important information including funeral notices, special programs, changes due to weather, etc.), phone blasts, and, rarely, regular mail. Please indicate if you wish to receive emails and phone calls and which phone number (home phone and/or cell phone) should be used. (can pick more than one)
Personal email
Family email
Cell phone
Home phone
Marital status
Married
Single
Separated
Divorced
Widowed
Is person Jewish?
Yes
No
Please provide details, if needed
If Jewish, Hebrew name. Please include parents' Hebrew names.
Occupation (if retired, enter previous career)
Please select
Advertising/writing
Business
Construction
Culinary Arts
Education
Electrician
Engineering
Financial
Framing
Graphic design
Healthcare/Medical
Insurance
Law
Music
Plumbing
Real Estate
Sales
Social work
Speech
Technology
Name of business
LinkedIn handle
Instagram handle
Facebook handle
*
How did you hear of us? If a referral, please mention member name.
Prior synagogue affiliation
City
State
Zip code
Did you make a building fund payment at your previous temple?
Yes, and I'll send proof to financial.secretary@bisrael.com
No, and I'd like to pay in full, with a discounted price
No, and I'd like to make 4 payments over 4 years
Children:
First name
Last name, if different
Cell phone number
Email address
Date of birth
Hebrew name
Will child attend Hebrew school?
If yes, please provide information about previous Hebrew school education (where & years attended)
No, I understand my child must attend 5 years of Hebrew school
First name
Last name, if different
Cell phone number
Email address
Date of birth
Hebrew name
Will child attend Hebrew school?
If yes, please provide information about previous Hebrew school education (where & years attended)
No, I understand my child must attend 5 years of Hebrew school
First name
Last name, if different
Cell phone number
Email address
Date of birth
Hebrew name
Will child attend Hebrew school?
If yes, please provide information about previous Hebrew school education (where & years attended)
No, I understand my child must attend 5 years of Hebrew school
First name
Last name, if different
Cell phone number
Email address
Date of birth
Hebrew name
Will child attend Hebrew school?
If yes, please provide information about previous Hebrew school education (where & years attended)
No, I understand my child must attend 5 years of Hebrew school
Congregation B’nai Israel values its volunteers and has a number of clubs, committees and programs in which your participation would be very welcome. Please indicate your interest by checking next to those of interest for each adult:
Activities for Adult #1
Adult Ed
Community Care Committees: Good & Welfare, Club Chesed
Finance
Food & Hospitality
Fundraising
Gift Shop
Green Group (Environmental Committee)
Hebrew School
High Holiday Assistance
House & Grounds
Interfaith Outreach
Membership
Men’s Club
Publicity/Communications
Ritual Committee
Significant Seniors
Sisterhood
Social Action
Special Events & Programming
Technology
Temple Newsletter (the Menorah)
Website & Social Media
Other
Activities for Adult #2
Adult Ed
Community Care Committees: Good & Welfare, Club Chesed
Finance
Food & Hospitality
Fundraising
Gift Shop
Green Group (Environmental Committee)
Hebrew School
High Holiday Assistance
House & Grounds
Interfaith Outreach
Membership
Men’s Club
Publicity/Communications
Ritual Committee
Significant Seniors
Sisterhood
Social Action
Special Events & Programming
Technology
Temple Newsletter (the Menorah)
Website & Social Media
Other
If needed, which services could you attend on short notice to complete a minyan?
Friday night
Saturday morning
Sunday morning
Shiva service
Hobbies
Hobbies
Board games
Cards
Cooking
Dancing
Gardening
Hiking
Movies
Reading
Travel
Other
Please Select One
Requested dues deposit of $150
Please consider an additional dues deposit
Tue, September 26 2023 11 Tishrei 5784