Temple Beth El Membership Application

Thank you for your interest in joining Temple Beth El.

Any person of the Jewish faith, any person studying for conversion, any partner of a Jew who wishes to associate with the Jewish faith, or the custodial parent of a Jewish child may be elected to regular membership on approval by the Board of Directors.

Your application will be forwarded to the Membership Committee, and then on to the Board of Directors, which meets monthly. You will receive a New Member Packet once your membership application has been approved.

Note: Temple Beth El relies on the annual financial commitment of its congregants to allow us to provide the services we offer to the Jewish community of Humboldt County. The commitment level we request is 2% of each member unit’s Adjusted Gross Income from your most recent tax return. If you have the ability to make a greater commitment, please consider doing so.

Application Date *

Month

Day

Year

Please check the box that describes your eligibility status. *

If Other, please explain

Full Name (Adult One) *

Preferred Pronoun (Adult One)

Full Name (Adult Two)

Preferred Pronoun (Adult Two)

Street Address *

City *

State *

Zip *

Home/Cell Phone (Adult One) *

Home/Cell Phone (Adult Two)

Email (Adult One) *

Email (Adult Two)

Place of Birth (Adult One) *

Birthdate (Adult One) *

Month

Day

Year

Place of Birth (Adult Two)

Birthdate (Adult Two)

Month

Day

Year

Hebrew Name (Adult One)

Hebrew Name (Adult Two)

Occupation (Adult One) *

Occupation (Adult Two)

Name of Business (Adult One)

Name of Business (Adult Two)

Business Location (Adult One)

Business Location (Adult Two)

Business Phone (Adult One)

Business Phone (Adult Two)

Reasons for Joining Temple Beth El *

Referred By

Name of Jewish Organization or Synagogue *

Please provide name and location of institution, and years of affiliation

Person to contact to verify Jewish affiliation *

Email of Contact Person *

Religious Tradition (Adult One) *

Phone Number of Contact Person or Organization/Synagogue *

Religious Tradition (Adult Two)

Hebrew Fluency (Adult One) *

Hebrew Fluency (Adult Two)

Jewish Education (Adult One) *

Jewish Education (Adult Two)

KSA Description

For any of the knowledge, skills and abilities selected above, please indicate if for adult one or adult two, and provide any relevant details.

Other Experience

Please describe any other experience pertinent to Temple Beth El

Frist Name (Minor Child One)

Last Name (Minor Child One)

Nickname (Minor Child One)

Hebrew Name (Minor Child One)

Date of Birth Minor Child One)

Gender (Minor Child One)

School (Minor Child One)

Previous Jewish Education (Minor Child One)

Jewish Summer Camp Experience (Minor Child One)

Experience in NFTY or other Youth Programs (Minor Child One)

Will Attend TBE Religious School? (Minor Child One)

Future TBE B'nai Mitzvah? (Minor Child One)

Interest in TBE Youth Group? (Minor Child One)

Frist Name (Minor Child Two)

Last Name (Minor Child Two)

Nickname (Minor Child Two)

Hebrew Name (Minor Child Two)

Date of Birth (Minor Child Two)

Gender (Minor Child Two)

School (Minor Child Two)

Previous Jewish Education (Minor Child Two)

Jewish Summer Camp Experience (Minor Child Two)

Experience in NFTY or other Youth Programs (Minor Child Two)

Will Attend TBE Religious School? (Minor Child Two)

Future TBE B'nai Mitzvah? (Minor Child Two)

Interest in TBE Youth Group? (Minor Child Two)

First Name (Minor Child Three)

Last Name (Minor Child Three)

Nickname (Minor Child Three)

Hebrew Name (Minor Child Three)

Date of Birth (Minor Child Three)

Gender (Minor Child Three)

School (Minor Child Three)

Previous Jewish Education (Minor Child Three)

Jewish Summer Camp Experience (Minor Child Three)

Experience in NFTY or other Youth Programs (Minor Child Three)

Will Attend TBE Religious School? (Minor Child Three)

Future TBE B'nai Mitzvah? (Minor Child Three)

Interest in TBE Youth Group? (Minor Child Three)

Adult Children

Please provide names & ages of any adult children

Grandchildren

Please provide names & ages of any grandchildren

Other Relatives or Special Relationships

Yahrzeit - Remembering Departed Relatives

Please provide the full name, relationship, and date of death for each of those whom you would like to remember.

Leave this field blank