Membership Application Adult Member One Title Last name * First name * Preferred name or nickname Home address * City * State * Select stateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP code * Date of birth (MM/DD/YYYY) * Cell phone number * Email address * Marital status SingleMarriedEngagedDivorcedWidowedSeparatedPartneredNot applicable Anniversary date (MM/DD/YYYY), if applicable Hebrew name, if applicable Religious affiliation Adult Member Two If Applicable Title Last name First name Preferred name or nickname Date of birth (MM/DD/YYYY) Cell phone number Email address Hebrew name, if applicable Religious affiliation Household and Background Former synagogue or house of worship affiliation, if any Do you have children? YesNo How did you hear about Congregation of Israel? Do you have relatives who are members of Congregation of Israel? If so, please list their names, which household member they are related to, and their relationship. Get Involved Which activities would you like to learn more about? Select all that apply. Social justice and community engagementChoir or music teamAdult educationSisterhood Women’s GroupBrotherhood Men’s GroupBar/Bat Mitzvah preparationLearning to read Torah How We Can Support Your Household Are there accessibility needs or accommodations that would help anyone in your household participate fully in congregational life? Please tell us what would be helpful. Your Decision to Join What factors contributed to your decision to join Congregation of Israel? Membership Commitments Participation. Congregation of Israel offers many ways to connect through worship, classes, events, community engagement, and tikkun olam. I/we agree to participate in services, classes, events, or other congregational activities each quarter. I/we acknowledge the participation commitment. Financial support. Member contributions help maintain our house of worship and sustain its programs. I/we agree to make ongoing contributions or donations to Congregation of Israel. I/we acknowledge the financial support commitment.
