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New Membership Application

 

Is there a second adult in household?

Enter Adult B last name

Enter home phone

Enter how you would prefer your mail be addressed.
For example: Rabbi Joe Doe and Ms. Elaine Stit

Enter street address

Enter apartment number

Enter city name

Enter street address

Enter apartment number

Enter city name

Enter street address

Enter apartment number

Enter city name


For further information on membership types/dues, CLICK HERE.


Mr., Mrs., Ms., Rabbi, Dr., Professor

Mr., Mrs., Ms., Rabbi, Dr., Professor


Do you have minor or college age children?

Please provide information if any child has a last name different than primary parent or the Hebrew name of the father or mother is different than Adult A and/or B.  One line per child.



Do you (or any members of your household) observe a yahrzeit?

If so, how many yahrzeits are observed in the household?

Other information if needed.  

Waiver

I hereby apply for membership for my household in Congregation Beth Sholom, Teaneck, and, if accepted, agree to abide by its Constitution and bylaws. I have been informed of the applicable dues structure and building fund obligation and building fund obligation and agree to accept the financial obligations of membership in Beth Sholom.  I also understand that submission of this form allows use of any photographs taken at events/activities related to the synagogue to be used in any form of public relations inclusive of website and social media.  

Mon, July 22 2019 19 Tammuz 5779