Application for Membership - Form

Application for Membership

Welcome! We're delighted that you're interested in joining our Temple Beth El community. Our members are young and old, married and single, with and without children. Although they primarily live in Western Massachusetts and Northern Connecticut, we also have long-time members who have moved to other parts of the country and still maintain their membership and deep connection to Temple Beth El.

Click HERE to view all membership options and pricing.

One of the values at TBE is that finances should never be a barrier for membership. To discuss a payment plan that works for you, please contact our Executive Director, Sonia Wilk.

Please feel free to participate in our services, classes and special programs to get a feel for our warm and welcoming community.

We look forward to meeting you!

When completing this form, you will notice a red asterisk next to many of the questions. This means that an answer to the question is required. If you do not know the answer, please type "Unknown" and if the question does not apply to you, please type "Not Applicable."

* Choose your membership category that applies to you:

Household MembershipIndividual MembershipAssociate Membership

Please select your category

What can you afford?

What synagogue do you belong to?

ADULT 1 INFORMATION ADULT 1 INFORMATION

* First Name

* Last Name

* Date of Birth

* Gender

Jewish - Yes or No

Hebrew Name (in English)

* Email

Cell Phone

* Employer Name

Occupation/Role

Employer Phone

Please check the box(es) that describe your interests.

* Is there a second adult applying for membership?

ADULT 2 INFORMATION

* First Name

* Last Name

* Date of Birth

* Gender

Jewish - Yes or No

Hebrew Name (in English)

* Email

Cell Phone

* Employer Name

Occupation/Role

Employer Phone

Please check the box(es) that describe your interests.

HOUSEHOLD INFORMATION

* Street Address Line 1

Street Address Line 2

* State

* City

* Zip Code

* Home Phone

CHILDREN CURRENTLY LIVING IN HOUSEHOLD

* How many children are living in your household?

Child 1 - Name

Child 1 - Gender

Child 1 - Date of Birth

Child 1 - School

Child 1 - Grade

Child 2 - Name

Child 2 - Gender

Child 2 - Date of Birth

Child 2 - School

Child 2 - Grade

Child 3 - Name

Child 3 - Gender

Child 3 - Date of Birth

Child 3 - School

Child 3 - Grade

Child 4 - Name

Child 4 - Gender

Child 4 - Date of Birth

Child 4 - School

Child 4 - Grade

ADDITIONAL INFORMATION

List of other household members; Name, relationship and age

Are you related to any current or previous TBE members. If yes, please list below and include your relationship to them.

YAHRZEIT OBSERVANCES

Would you like to provide Yahrzeit observances to receive notices?

English Name of Deceased

Hebrew Name of Deceased

English date of Death (MM/DD/YYYY)

Gender

Observer

Relationship to Deceased

English Name of Deceased

Hebrew Name of Deceased

English date of Death (MM/DD/YYYY)

Gender

Observer

Relationship to Deceased

English Name of Deceased

Hebrew Name of Deceased

English date of Death (MM/DD/YYYY)

Gender

Observer

Relationship to Deceased

English Name of Deceased

Hebrew Name of Deceased

English date of Death (MM/DD/YYYY)

Gender

Observer

Relationship to Deceased

AGREEMENTS

Membership Directory - Please check whether or not you give permission for us to publish your name, address, telephone, and email address in the synagogue's membership directory.

I give permission to publish my name, address, telephone number, and email address in the synagogue’s Membership Directory.I do not give permission to publish my name, address, telephone number, and email address in the synagogue’s Membership Directory.

* I/We agree to pay for the support and maintenance of the synagogue through dues and associated fees.

I/We agree to pay for the support and maintenance of the synagogue through dues and associated fees.