NEW MEMBER INFORMATION
NEW MEMBER INFORMATION
We ask that all new members fill out this form as completely as possible. Thank you.
MEMBER (PRIMARY):
MEMBER (SECONDARY):
Name: Address:
_______________________________ _______________________________ _______________________________ Phone (H): _______________________________ Phone (W): _______________________________ Phone (C): _______________________________ Email: _______________________________ Occupation: _______________________________ Employer: _______________________________ Hebrew Name: _________________________ Bar/Bat Mitzvah: _________________________ Date of Birth: _________________________ Mother’s Hebrew Name: ___________________ Father’s Hebrew Name: ___________________ Are you part of an interfaith family? Yes No Date Joined B’nai Havurah (approx.) _____________ Current Havurah: _________________________ Are you interested in joining a Havurah? Yes No Do you consider yourself Jewish? Yes No
Name: Address:
What synagogue activities, committees or programs are of interest to you?
What synagogue activities, committees or programs are of interest to you?
Tikkun Olam Chesed Ritual/Prayer Membership Budget/Finance Fundraising Library High Holy Days Shabbat Host/Hostess
Bar/Bat Mitzvah Personnel Information Technology Development/Fundraising Religious School Adult Education Inclusivity Other Holidays Choir
_______________________________ _______________________________ _______________________________ Phone (H): _______________________________ Phone (W): _______________________________ Phone (C): _______________________________ Email: _______________________________ Occupation: _______________________________ Employer: _______________________________ Hebrew Name: _________________________ Bar/Bat Mitzvah: _________________________ Date of Birth: _________________________ Mother’s Hebrew Name: ___________________ Father’s Hebrew Name: ___________________ Are you part of an interfaith family? Yes No Date Joined B’nai Havurah (approx.) _____________ Current Havurah: _________________________ Are you interested in joining a Havurah? Yes No Do you consider yourself Jewish? Yes No
Tikkun Olam Chesed Ritual/Prayer Membership Budget/Finance Fundraising Library High Holy Days Shabbat Host/Hostess
Bar/Bat Mitzvah Personnel Information Technology Development/Fundraising Religious School Adult Education Inclusivity Other Holidays Choir
Other___________________
Other___________________
What are your special skills and talents? _______________________________________________ _______________________________________________ _______________________________________________
What are your special skills and talents? _______________________________________________ _______________________________________________ _______________________________________________
YAHRZEITS: Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Please feel free to attach an additional piece of paper, or email the office at [email protected] if you have additional yahrzeits.
It is customary to light a yahrzeit candle on the eve of a yahrzeit date. It is also considered a mitzvah in Jewish tradition to honor the memory of a loved one by giving tzedakah. In our B'nai Havurah community, we have found that a particularly special way to honor a loved one is to sponsor a Shabbat Kiddush in his or her memory. Please feel free to call the office at 303-388-4441 or email us at [email protected] if you have any questions concerning our yahrzeit customs.
CHILDREN (RESIDING WITH YOU): FULL NAME
HEBREW NAME M/F
SCHOOL GRADE
ENROLLED AT BH RELIGIOUS SCHOOL?
DATE OF BIRTH
_________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________
CHILDREN NOT RESIDING WITH YOU (OF ALL AGES): NAME
PHONE
EMAIL ADDRESS
_________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________
EMERGENCY CONTACT INFORMATION: FULL NAME
PHONE
EMAIL ADDRESS
1._______________________________________________________________________________________ 2._______________________________________________________________________________________
Your signature below authorizes B’nai Havurah to use images of members of your household for various marketing pieces, including our website and annual reports, unless you indicate “NO” here:______.
____________________________________________________________ Signature(s)
_______________________ Date
How did you hear about B’nai Havurah?
_________________________________________________________________________________________ _________________________________________________________________________________________ What attracted you to B’nai Havurah?
_________________________________________________________________________________________ _________________________________________________________________________________________
We ask that all new members fill out this form as completely as possible. Thank you.
MEMBER (PRIMARY):
MEMBER (SECONDARY):
Name: Address:
_______________________________ _______________________________ _______________________________ Phone (H): _______________________________ Phone (W): _______________________________ Phone (C): _______________________________ Email: _______________________________ Occupation: _______________________________ Employer: _______________________________ Hebrew Name: _________________________ Bar/Bat Mitzvah: _________________________ Date of Birth: _________________________ Mother’s Hebrew Name: ___________________ Father’s Hebrew Name: ___________________ Are you part of an interfaith family? Yes No Date Joined B’nai Havurah (approx.) _____________ Current Havurah: _________________________ Are you interested in joining a Havurah? Yes No Do you consider yourself Jewish? Yes No
Name: Address:
What synagogue activities, committees or programs are of interest to you?
What synagogue activities, committees or programs are of interest to you?
Tikkun Olam Chesed Ritual/Prayer Membership Budget/Finance Fundraising Library High Holy Days Shabbat Host/Hostess
Bar/Bat Mitzvah Personnel Information Technology Development/Fundraising Religious School Adult Education Inclusivity Other Holidays Choir
_______________________________ _______________________________ _______________________________ Phone (H): _______________________________ Phone (W): _______________________________ Phone (C): _______________________________ Email: _______________________________ Occupation: _______________________________ Employer: _______________________________ Hebrew Name: _________________________ Bar/Bat Mitzvah: _________________________ Date of Birth: _________________________ Mother’s Hebrew Name: ___________________ Father’s Hebrew Name: ___________________ Are you part of an interfaith family? Yes No Date Joined B’nai Havurah (approx.) _____________ Current Havurah: _________________________ Are you interested in joining a Havurah? Yes No Do you consider yourself Jewish? Yes No
Tikkun Olam Chesed Ritual/Prayer Membership Budget/Finance Fundraising Library High Holy Days Shabbat Host/Hostess
Bar/Bat Mitzvah Personnel Information Technology Development/Fundraising Religious School Adult Education Inclusivity Other Holidays Choir
Other___________________
Other___________________
What are your special skills and talents? _______________________________________________ _______________________________________________ _______________________________________________
What are your special skills and talents? _______________________________________________ _______________________________________________ _______________________________________________
YAHRZEITS: Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Name: Hebrew Name: Relationship: Date of Death:
_________________________________ _________________________________ _________________________________ _________________________________
Please feel free to attach an additional piece of paper, or email the office at [email protected] if you have additional yahrzeits.
It is customary to light a yahrzeit candle on the eve of a yahrzeit date. It is also considered a mitzvah in Jewish tradition to honor the memory of a loved one by giving tzedakah. In our B'nai Havurah community, we have found that a particularly special way to honor a loved one is to sponsor a Shabbat Kiddush in his or her memory. Please feel free to call the office at 303-388-4441 or email us at [email protected] if you have any questions concerning our yahrzeit customs.
CHILDREN (RESIDING WITH YOU): FULL NAME
HEBREW NAME M/F
SCHOOL GRADE
ENROLLED AT BH RELIGIOUS SCHOOL?
DATE OF BIRTH
_________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________
CHILDREN NOT RESIDING WITH YOU (OF ALL AGES): NAME
PHONE
EMAIL ADDRESS
_________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________
EMERGENCY CONTACT INFORMATION: FULL NAME
PHONE
EMAIL ADDRESS
1._______________________________________________________________________________________ 2._______________________________________________________________________________________
Your signature below authorizes B’nai Havurah to use images of members of your household for various marketing pieces, including our website and annual reports, unless you indicate “NO” here:______.
____________________________________________________________ Signature(s)
_______________________ Date
How did you hear about B’nai Havurah?
_________________________________________________________________________________________ _________________________________________________________________________________________ What attracted you to B’nai Havurah?
_________________________________________________________________________________________ _________________________________________________________________________________________
