Membership Application

Thank you for your interest in joining Congregation Ahavat Achim. Please complete this application form (for our internal purposes). Thank-you.
Type of Membership*
- Full
- Associate
Family Name*
Address*
Street Address Address Line 2 City State ZIP Code
Cell Phone #1*
Cell Phone #2
Email #1*
Email #2
I/we acknowledge that we have received a copy of Ahavat Achim’s Constitution and current Membership Fee Schedule. I/we agree that when we become members of Ahavat Achim, we assume the financial obligations outlined in the Constitution and Membership Fee Schedule, and that I am/we are legally and ethically bound to fulfill these obligations in a timely manner in accordance with the Constitution.
Applicant #1 - Signature*
Applicant #2 - Signature
Do you currently have unpaid dues, pledges, or other financial obligations to another synagogue?*
- Yes
- No
If yes, please explain below:

Male Adult
Male Adult - English Name
Title First Last
Male Adult - Hebrew Name
Male Adult - Father's Hebrew Name
Male Adult - Mother's Hebrew Name
Male Adult - Birthday
Male Adult - Anniversary (if applicable)
Male Adult - Bar Mitzvah Parsha
Male Adult - Are you a...?
- Kohen
- Levi
- Yisroel
Male Adult - Yahrzeits (if applicable)
*Please use the Hebrew date (if known). If unknown, please use complete date (MM/DD/YYYY).
Relationship Hebrew Name Son/Daughter of (Hebrew Name) Date of Yahrzeit*
Male Adult - Committees
I would like to volunteer to work on the following committees (please circle):
- Advertising/Marketing
- Bulletin
- Chesed
- Chevra Kadisha
- Education
- Fundraising
- Hospitality
- House/Building
- Membership
- Men's Club
- Shiva
- Other
Male Adult - Skills and Abilities
I have the following skills/abilities that I would like to share with the congregation:
- Ba’al Tefila (Davening)
- Ba’al Kriah (Torah Reading)

Female Adult
Female Adult - English Name
Title First Last
Female Adult - Hebrew Name
Female Adult - Father's Hebrew Name
Female Adult - Mother's Hebrew Name
Female Adult - Birthday
Female Adult - Anniversary (if applicable)
Female Adult - Bat Mitzvah Parsha
Female Adult - Yahrzeits (if applicable)
*Please use the Hebrew date (if known). If unknown, please use complete date (MM/DD/YYYY).
Relationship Hebrew Name Son/Daughter of (Hebrew Name) Date of Yahrzeit*
Female Adult - Committees
I would like to volunteer to work on the following committees (please circle):
- Advertising/Marketing
- Bulletin
- Chesed
- Chevra Kadisha
- Education
- Fundraising
- Hospitality
- House/Building
- Membership
- Men's Club
- Shiva
- Other

Children
Children Living at Home
English Name Hebrew Name Birthday (mm/dd/yy) Current School Grade Bar/Bat Mitzvah Parsha Email
Children Not Living at Home
Please include sons/daughters-in-law.
English Name Hebrew Name Birthday (mm/dd/yy) Current School Grade Bar/Bat Mitzvah Parsha Email Relationship
Were all members of your family born Jewish?
- Yes
- No
Is there anything else you would like us to know about you and/or your family (accommodations, special needs, talents and interests, etc.)?

Male Adult

Relationship	Hebrew Name	Son/Daughter of (Hebrew Name)	Date of Yahrzeit*

English Name	Hebrew Name	Birthday (mm/dd/yy)	Current School	Grade	Bar/Bat Mitzvah Parsha	Email