Membership Application - Form - Congregation Or Zarua

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Membership Application

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* Preferred Family Name

Home Phone

* Email

* Address

* City

* State

* Zip Code

* First Name

Middle Name

* Last Name

Hebrew Name

Please write your Hebrew name in this format: (Your name) ben/bat (Father's Hebrew Name) and (Mother's Hebrew Name)

Email Address

Cell Phone

Are you a...

* Is/was your birth mother Jewish?

* Date of Birth

* Marital Status

Date of Marriage (if Married)

Profession

Employer

Work Phone

Work Email

Business - Address

Business - City

Business - State

Business - Zip Code

* Torah or Haftarah reader?

* Davening leader?

* Would you like to learn either?

* Would you like to be included in our Shabbat hospitality program for new members?

Please indicated any interest in the following Or Zarua activities:

Morning MinyanWeekly Talmud ClassesBook ClubHesed Committee

Hevra KadishaUsheringEvent PlanningHelping with synagogue mailings

NewsletterGraphic DesignYouth/teen programming

Any special interests or concerns?

* Is there a second Adult applying for Membership?

* First Name

Middle Name

* Last Name

Hebrew Name

Please write your Hebrew name in this format: (Your name) ben/bat (Father's Hebrew Name) and (Mother's Hebrew Name)

Email Address

Cell Phone

Are you a...

* Is/was your birth mother Jewish?

* Date of Birth

* Would you like to be included in our Shabbat hospitality program for new members?

Profession

Employer

Work Phone

Work Email

Business - Address

Business - City

Business - State

Business - Zip Code

* Torah or Haftarah reader?

* Davening leader?

* Would you like to learn either?

* Would you like to be included in our Shabbat hospitality program for new members?

Please indicated any interest in the following Or Zarua activities:

Morning MinyanWeekly Talmud ClassesBook ClubHesed Committee

Hevra KadishaUsheringEvent PlanningHelping with synagogue mailings

NewsletterGraphic DesignYouth/teen programming

Any special interests or concerns?

* Does Adult 2 live at the same address?

* Adult 2 - Address

* Adult 2 - City

* Adult 2 - State

* Adult 2 - Zip Code

How many children do you have?

* Child 1 - English Name

Child 1 - Date of Birth

Child 1 - Born before sunset?

Child 1 - Hebrew Name

* Child 1 - Birth mother Jewish?

Child 1 - If mother converted prior to Child's Birth, please enter the Date, Place and name of Officiating Rabbi.

Child 1 - If child converted, please enter the Date, Place and name of Officiating Rabbi.

Child 1 - School

Child 1 - Grade/Year

* Child 2 - English Name

Child 2 - Date of Birth

Child 2 - Born before sunset?

Child 2 - Hebrew Name

* Child 2 - Birth mother Jewish?

Child 2 - If mother converted prior to Child's Birth, please enter the Date, Place and name of Officiating Rabbi.

Child 2 - If child converted, please enter the Date, Place and name of Officiating Rabbi.

Child 2 - School

Child 2 - Grade/Year

* Child 3 - English Name

Child 3 - Date of Birth

Child 3 - Born before sunset?

Child 3 - Hebrew Name

* Child 3 - Birth mother Jewish?

Child 3 - If mother converted prior to Child's Birth, please enter the Date, Place and name of Officiating Rabbi.

Child 3 - If child converted, please enter the Date, Place and name of Officiating Rabbi.

Child 3 - School

Child 3 - Grade/Year

* Child 4 - English Name

Child 4 - Date of Birth

Child 4 - Born before sunset?

Child 4 - Hebrew Name

* Child 4 - Birth mother Jewish?

Child 4 - If mother converted prior to Child's Birth, please enter the Date, Place and name of Officiating Rabbi.

Child 4 - If child converted, please enter the Date, Place and name of Officiating Rabbi.

Child 4 - School

Child 4 - Grade/Year

* How many yahrzeits do you have?

Yahrzeit 1 - English Name

Yahrzeit 1 - Relation

Yahrzeit 1 - Hebrew Name

(Name) ben/bat (Father's Hebrew Name) and (Mother's Hebrew Name)

Yahrzeit 1 - Date of Death

Yahrzeit 1 - Was the death before sunset?

Yahrzeit 2 - English Name

Yahrzeit 2 - Relation

Yahrzeit 2 - Hebrew Name

(Name) ben/bat (Father's Hebrew Name) and (Mother's Hebrew Name)

Yahrzeit 2 - Date of Death

Yahrzeit 2 - Was the death before sunset?

Yahrzeit 3 - English Name

Yahrzeit 3 - Relation

Yahrzeit 3 - Hebrew Name

(Name) ben/bat (Father's Hebrew Name) and (Mother's Hebrew Name)

Yahrzeit 3 - Date of Death

Yahrzeit 3 - Was the death before sunset?

Yahrzeit 4 - English Name

Yahrzeit 4 - Relation

Yahrzeit 4 - Hebrew Name

(Name) ben/bat (Father's Hebrew Name) and (Mother's Hebrew Name)

Yahrzeit 4 - Date of Death

Yahrzeit 4 - Was the death before sunset?

How did you learn about Congregation Or Zarua?

* Do you read The Jewish Week?

* Do you have a cemetery plot?

If so, where?

* Might you be interested in a plot in Or Zarua's cemetery ?

Sat, June 3 2023 14 Sivan 5783

Back to www.orzarua.org

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