Membership Application

We are so happy you have made the decision to join The Emanuel Synagogue!

We look forward to sharing holidays, joyous occasions and opportunities for learning with you and your family. We look forward to getting to know each other. Please complete the form below, and if you have any questions, please contact Jacob Schreiber, Executive Director at jacob@emanuelsynagogue.org.

How did you hear about The Emanuel Synagogue?

ADULT 1 INFORMATION

Title

Optional

* First Name

Nickname

Middle Name

* Last Name

Maiden Name

Gender

Pronouns

* Birthdate

* Email Address

* Cell

555 -555-5555

Hebrew Name

Father Hebrew Name

Mother Hebrew Name

Tribe at Birth

If you don't have a Hebrew name do you want one?

Business Name

Occupation

Business Phone

555-555-5555

Please share your hobbies or interests with us.

ADULT 2 INFORMATION (IF RELEVANT)

Title

Optional

First Name

Nickname

Middle Name

Last Name

Maiden Name

Gender

Pronouns

* Birthdate

Email Address

Cell

555-555-5555

Hebrew Name

Father Hebrew Name

Mother Hebrew Name

Tribe at Birth

If you don't have a Hebrew name would you want one?

Business Name

Occupation

Business Phone

555-555-5555

Please share your hobbies and interests with us

HOUSEHOLD INFORMATION

* Home Street Address

* City

* State

* Zip Code

Home Phone Number

Marital Status

Anniversary

CHILDREN

Do you have any children? Please include all children even if they are adults

First Name

Nickname

Middle Name

Last Name

Gender

Pronouns

Birthday

After Sunset?

Tribe

Hebrew Name

Parent 1 Hebrew Name

Parent 2 Hebrew Name

YAHRZEITS

Yahrzeit means anniversary of a death. It is a yearly anniversary of a loved one's death on the Hebrew calendar.

How many yahrzeits does your family observe?

* English Name of Deceased

Hebrew Name of Deceased

* Gender of Deceased

* English Date of Death

After Sunset?

* Observe Hebrew or English Date?

* Mourner in Family

* Relationship to Mourner

Deceased is XXX of mourner

Cemetery

WHICH OPPORTUNITIES WOULD YOU LIKE TO PARTICIPATE

Please enroll me/my family in membership in Emanuel Synagogue in the following membership category. For updated membership fees, please contact the Office at 860-236-1275.

Family/Couple Membership: Couple with or without children attending Religious SchoolSingle Parent Family Membership: Single parent and all children under age 22Individiual Adult Membership: Single adult with no children attending Religious School

A member of our membership team will contact you within 24 hours of receiving your application. We are so happy you chose to join The Emanuel Community!

Is there anything else you would like to share with us?

ADULT 1 INFORMATION

ADULT 2 INFORMATION (IF RELEVANT)

HOUSEHOLD INFORMATION

CHILDREN

YAHRZEITS

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