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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: Dr. Elaine Stit & Joe Doe
Enter street address
Enter apartment number
Enter city name
For further information on membership types and 2023 dues, CLICK HERE.
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.
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 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.