New Membership Application - Form - Congregation Beth Shalom

CONTACT INFORMATION

* Email Address

* First Name

Middle (Optional)

* Last Name

* Mailing Address 1

Mailing Address 2

* City

* State

Zip Code

* Home Phone

Mobile Phone

Business Phone

Occupation

Name of Business

Business Email

Martial Status

Maiden Name

* Birthdate

Anniversary Date

Current/Previous Synagogue Affiliation

Do you have Children?

Ages 0-18

Ages 18+

BACKGROUND PROFILE INFORMATION

Member 1 Hebrew Name

Member 2 Hebrew Name

Member 1 Converted to Judaism?

Member 2 Converted to Judaism?

Member 1 Bar/Bat Mitzvah Date

Member 2 Bar/Bat Mitzvah Date

Please list any relatives or friends at Congregation Beth Shalom

Member 1 Father Name

Member 2 Father Name

Member 1 Father Hebrew Name

Member 2 Father Hebrew Name

Member 1 Mother Name

Member 2 Mother Name

Member 1 Mother Hebrew Name

Member 2 Mother Hebrew Name

Member 1 Tribal Affiliation

Member 2 Tribal Affiliation

Member 1 Hebrew Knowledge/Synagogue Skills

Member 2 Hebrew Knowledge/Synagagoue Skills

Member 1 Can Chant Torah/Haftorah?

Member 2 Can Chant Tordah/Haftorah?

Yahrtzeit's Observed

Name

Relationship

English Date

Before of After Sundown

Relationship

English Date

Before of After Sundown

Name

Relationship

English Date

Before of After Sundown

Name

Relationship

English Date

Before of After Sundown

CHILDRENS INFORMATION (PLEASE INCLUDE ADULT CHILDREN AS WELL)
For the sake of space we have limited it to four children. Additional children? Mazel Tov! Please notify the office.

Child 1 Name

Child 2 Name

Child 3 Name

Child 4 Name

Child 1 Hebrew Name

Child 2 Hebrew Name

Child 3 Hebrew Name

Child 4 Hebrew Name

Child 1 Nickname

Child 2 Nickname

Child 3 Nickname

Child 4 Nickname

Child 1 Birthdate

Child 2 Birthdate

Child 3 Birthdate

Child 4 Birthdate

Child 1 Gender

Child 2 Gender

Child 3 Gender

Child 4 Gender

Child 1 Live with Parents?

Child 2 Live With Parents?

Child 3 Live With Parents?

Child 4 Live With Parents?

PARTICIPATORY REQUEST
Congregation Beth Shalom thrives because it's members actively participate in various aspects of Synagogue life. We hope that you will choose to become active as well!

Please select your interest in any of the following committees and/or social groups:

House Committee - Responsible for the proper maintenance of the buildings owned by the congregation andsupervising the care and maintenance of our lawns and gardens.Chevra Kadisha -In charge of the rituals for funeral preparation.Social Welfare Committee-Reach out to those who are bedridden or may need assistance keeping in touch with the community. Visit the sick and whoever may need some special attention; reach out to community service organizations.Adult Education Committee –Plans, facilitates and organizes adult education classes and activities.Fundraising Committee-Responsible for raising funds through the development of projects, programs and endowmentsProgramming -Plan and promote and bring programs of educational & cultural interest to our synagogue.Ritual Committee -Formulates rules and regulations compatible with Judaism for all services.Membership Committee -Active involvement in developing strategies to out reach out to prospective members, welcoming new members and retention of members.Youth Group-This committee will look after the welfare of the youths affiliated with the congregation, and shall provide for the activities of these youths.

Sisterhood

SisterhoodBeth Shalom Sisterhood provides a full program ofinvolvement for the modern Jewish woman. The Sisterhood operates our Judaica Shop and provides major financial support for the Synagogue and its Religious School. Our Sisterhood also participates in community service activities. Membership is open to any member in good standing of Beth Shalom.

Brotherhood

BrotherhoodMembership in Brotherhood of Beth Shalom is open to any member of Beth Shalom in good standing 18 years of age or older. The purpose of the Brotherhood is:

1.To strengthen the involvement of the members in the life of the congregation.
2.To promote friendship and fellowship among the members.
3.To integrate and advance the congregational institutions.
4.To promote a more thorough knowledge and appreciation of Jewish life.
5.To stimulate social and cultural activities among the members and in the community at large.
6.To train knowledgeable leaders for the synagogue and the Jewish community.
7.To promote the development of the synagogue.
8.Ushering at High Holiday Services

The Brotherhood has special outings and events, and supports the synagogue by working on various special projects.

Arlington Federation of Temple Youth

Arlington Federation of Temple YouthThe Youth Group of Congregation Beth shalom is active both local and regionally. Membership is open to children from the 4thgrade through high school. Activities include social events, community outreach, interaction with other youth groups.

Sylvia Gray Chaverim

Sylvia Gray ChaverimThis group is dedicated to adults age 50 and above, and offers fellowship and social activities.

TERMS AND AGREEMENT
The Board of Directors establishes annual membership dues and assessments. We use the Fair Share program for dues, with a recommended minimum amount as described in the dues form. A mandatory maintenance assessment of $40 annually as well as a mandatory security fee of $50 annually (totaling $90.00) is added to give us a reserve for unexpected repairs as well as protect the safety and well being of our congregants, visitors, and property.

A $300 building fund pledge, which may be paid over 3 years, is also requested of new members.

I/We Agree to the Terms Below

I/We Agree to the Terms BelowI understand that I/we will be responsible for all financial obligations agreed to by completing this application and that all of the information provided is correct and true, to the best of my knowledge, at the time of submission.