Shul Partnership

Welcome to our Community - Shul Partnership & Information - This information will be put into our Shul database so we can keep you updated on Shul related news.
Please select one:*

I would like to renew my membership. All my information remains the same. (Fill in the REQUIRED* text fields on the form below and go to section 6 for payment)I would like to renew my membership. Please note the changes to my information below. (Fill in the REQUIRED* text fields and other updated fields on the form below and go to section 6 for payment)I would like to become a member (Fill in all sections as applicable and go to section 6 for payment)We just moved in and are busy unpacking and getting settled . Please reach out to me in a bit for this info once we are more settled
SECTION I: YOUR INFO
Full Name*
First Name Last Name
Hebrew Name
E-mail
Cell Number

Area Code Phone Number
Occupation
Work Number

Area Code Phone Number
Father's Hebrew Name
Mother's Hebrew Name
English Full Birthday - our system converts it to hebrew

Month Day Year
Jewishness

From BirthConvertNot Jewish
Family

KohenLeviYisroel
SECTION II: YOUR SPOUSE'S INFO
Spouse Full Name
First Name Last Name
Spouse Hebrew Name
E-mail
Cell Number

Area Code Phone Number
Occupation
Work Number

Area Code Phone Number
Father's Hebrew Name
Mother's Hebrew Name
English Full Birthday - our system converts it to hebrew

Month Day Year
Jewishness

From BirthConvertNot Jewish
Family

KohenLeviYisroel
SECTION III: PERSONAL INFORMATION

Address

Home Number

Area Code Phone Number
Marital Status
Anniversary Date (English date)

Month Day Year
If divorced, do you have a Jewish "get"?

YesNo
SECTION IV: CHILDREN
Full Name
First Name Last Name
Birth Date English date

Month Day Year
Full Name
First Name Last Name
Birth Date English date

Month Day Year
Full Name
First Name Last Name
Birth Date English date

Month Day Year
Full Name
First Name Last Name
Birth Date English date

Month Day Year
Full Name
First Name Last Name
Birth Date English date

Month Day Year
Full Name
First Name Last Name
Birth Date English date

Month Day Year
SECTION V: YAHRZEIT INFORMATION
Name
Date of Passing

Month Day Year
Relationship
Name
Date of Passing

Month Day Year
Relationship
Other:
SECTION VI: ANNUAL PARTNERSHIP CONTRIBUTIONS
Partnership Plan
**All contributions are tax deductible and can be paid throughout the year. No one is turned away for lack of funds. If you cannot afford the full amount requested, please contact Rabbi Lieberman 954 394 7701 for a confidential arrangement.
Membership Options

1200100
Boy's Shabbos Program

18 Per month
Preschool & Girls Shabbos Program

$18 Per Month

Payment

Credit Card Please bill me

Postal / Zip Code

Country

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