New Membership Application

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* Member type

Affiliate members must be full members of another shul. Please indicate your primary shul membership if applying for Affiliate status.

* Other

* Do you expect to be renting our facility within the next 12 months?

* Address 1

Address 2

* City

* State

* Zip

Home Phone

Family tribe

* Adult 1 Last Name

Adult 2 Last Name (if different)

* Title

Spouse Title

* First name

Spouse first name

* Gender

Spouse gender

* Hebrew name (no parent name; please use English letters)

Spouse Hebrew name (no parent name; please use English letters)

* Father's Hebrew name (please use English letters)

* Spouse father's Hebrew name (please use English letters)

* Mother's Hebrew name (please use English letters)

Spouse mother's Hebrew name (please use English letters)

* Email

Spouse email

Cell phone

Spouse cell phone

Work phone

Spouse work phone

Birth date

Spouse birth date

Wedding anniversary

Profession

Spouse's profession

Rinat's programming and events are run by our members. We would love for you to be involved too! Please share any interests that you have.

How many children do you have?

Please enter your childrens' information

First Name

Middle

Last Name

Tribe

Birthday

Born after sunset?

Hebrew Name (use English characters)

Previous Shul you were a member of, including the name and phone number.

Please check if you would like to request our young couples discount (for members 33 and under)

Yahrzeits (please click the plus sign (+) to add as many as you need)

If anyone in your household observes a yahrzeit, please enter it here. Use the + sign to add

* Last Name of Deceased

* English Name of Deceased

Hebrew Name of Deceased

* Gender of the Deceased

Please Select OneMaleFemale

* English Date of Death

* After Sunset?

Please Select OneYesNo

* Mourners and Relationship of Deceased to Mourner

Other information (if needed)

Please upload a picture of your family

* Please check this box to accept financial responsibility per immediately below:

Please check this box to accept financial responsibility per immediately below:

I/we hereby apply for membership to Congregation Rinat Yisrael, as indicated above. I/we agree to accept the responsibilities which come with this membership, including financial obligations as incurred. This includes membership dues and building fund assessment, as determined by the board of directors, and any other charges I/we may incur during our membership at Congregation Rinat Yisrael. Current dues and building fund assessment amounts may be found at https://www.rinat.org/membershipinfo and may be changed from time to time, as needed.

* May we welcome you in our weekly news bulletin?

Please note that any changes or adjustments to membership must be done in writing to the shul office.