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New Membership Application

Member Primary Information
This will be the email address you use to log in to your Shulcloud account and receive statements and newsletters from the synagogue. Please choose an address you check regularly.
Please provide the number you can most reliably be contacted at.
Please include apartment or unit numbers. Ex: 221 Baker St. Unit B
(Please write it in English letters - e.g. Baruch ben Dov v’Ruth)

Member Secondary Information (if applicable)
*For interfaith families, membership will be listed under the Jewish spouse.
This will be the email address your secondary uses to log in to your family's Shulcloud account and receive statements and newsletters from the synagogue. Please choose an address that is checked regularly.
Please provide the number this person can most reliably be contacted at.
(Please write it in English letters - e.g. Baruch ben Dov v’Ruth)

Children (if applicable)
Example: Peter Parker, 4/13/2002, New York High School, allergic to peanuts
Yahrzeits
As a courtesy for our members, Beth Shalom sends out reminder letters a few weeks in advance of a Yahrzeit. Member Yahrzeits are also published in our monthly and weekly newsletters, and read from the bima on Shabbat. If you would like to receive these reminders, please fill out the box below according to the example shown. You may give this information to the office at any time
Example: Benjamin Parker, 5/4/2017, uncle of Peter Parker
Previous Synagogue Affiliaton (if applicable)

As a member of Congregation Beth Shalom, I/we agree to abide by the rules, bylaws and acts of the Board of Directors including the payment of dues and other financial obligations.
Sun, December 5 2021 1 Tevet 5782