Membership Application
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Date: ______
Member ID: ______
Membership Application 2017-2018
Member 1 Full Name: ______- ______Nickname: ______Hebrew Name: ______Gender: M or F Birthdate: ______Member 1 Cell: ______Member 1 Email: ______Preferred method of communication (please circle one): Phone Email Text Member 1 Occupation: ______Member 1 Employer: ______Tell us about yourself (hobbies, talents, etc.): ______How were you raised? Reconstructionist Reform Conservative Orthodox Other: ______Jew by Choice: Conversion Date: ______Rabbi: ______
Member 2 Full Name: ______- ______Nickname: ______Hebrew Name: ______Gender: M or F Birthdate: ______Member 2 Cell: ______Member 2 Email: ______Preferred method of communication (please circle one): Phone Email Text Member 2 Occupation: ______Member 2 Employer: ______Tell us about yourself (hobbies, talents, etc.): ______How were you raised? Reconstructionist Reform Conservative Orthodox Other: ______Jew by Choice: Conversion Date:______Rabbi: ______Home Address: __- ______Landline Home Phone Number: ______Marital Status: (circle one) Single Married Divorced Separated Widowed Anniversary Date: ______
Membership Type: (check one) Family with 2 parents in the house with 1 or more children ____ 22-30 years ____ 31-59 years ____ 60+ years Family with 1 parent in the house with 1 or more children ____ 22-30 years ____ 31-59 years ____ 60+ years Family with 2 adults ____ 22-30 years ____ 31-59 years ____ 60+ years Single Adult ____ 22-30 years ____ 31-59 years ____ 60+ years CHILDREN
Child 1 Full Name: ______Nickname: ______Hebrew Name: ______Gender: M or F Birthdate: ______Cell Phone: ______Grade/College: ______
Child 2 Full Name: ______Nickname: ______Hebrew Name: ______Gender: M or F Birthdate: ______Cell Phone: ______Grade/College: ______
Child 3 Full Name: ______Nickname: ______Hebrew Name: ______Gender: M or F Birthdate: ______Cell Phone: ______Grade/College: ______
Child 4 Full Name: ______Nickname: ______Hebrew Name: ______Gender: M or F Birthdate: ______Cell Phone: ______Grade/College: ______
YAHRZEIT REMINDERS *You MUST list month, date, and year to receive yahrzeit letters
Deceased Full Name: ______Relationship:______to Member 1 or 2 (please circle one) Full English Date: ______OR Full Hebrew Date:______
Deceased Full Name: ______Relationship:______to Member 1 or 2 (please circle one) Full English Date: ______OR Full Hebrew Date:______
Deceased Full Name: ______Relationship:______to Member 1 or 2 (please circle one) Full English Date: ______OR Full Hebrew Date:______
Interested in ordering a yahrzeit plaque? Contact the office for an order form.
Would you like a special memory read aloud on your family member’s yahrzeit? Help us put a face to your loved one’s name by submitting a yahrzeit memory story or poem. Check any boxes that you’re interested in and you’ll hear back from those committees!
Membe Member Member Member ACTIVITIES COMMITTEES r 1 2 1 2 Adult Bar / Bat Mitzvah Class Adult Education Adult Hebrew Class Board of Trustees Brotherhood (Men of Emanuel) Fundraising Chavurah (Circle of Friends) Leadership Development Choir Library Discovering Judaism Class Membership Giving Circle Oneg Klezmer/Shabba-tones Bands Judaica Shop Hiking Preschool Sisterhood Event Programming Temple Youth Group TETY Ritual Torah Study Religious School Book Group Social Justice Women’s Perspectives on Torah Youth Yarn Yentas Theatre Club Wine Club
How did you hear about our congregation?
What prompted you to choose Temple Emanuel?
What are you most hoping to get out of your membership of Temple Emanuel?
Is there anything else you would like us to know about you and/or your family?
I/We, the undersigned, hereby submit application for membership to Temple Emanuel of Tempe. I/We agree to abide by its rules and by-laws.
Signature: ______Date: ______
Signature: ______Date: ______
Please submit a family photo via email to [email protected]