Membership Application

Adult Applicant 1

Name

Date of Birth (mm/dd/yyyy)

Pronouns (he/she/they/etc.)

This address will receive a confirmation email

Best Phone Number

Second Phone Number

Address

Marital Status

Occupation

Is this the first time you've become a member of a Jewish Congregation?

Yes No

If no, please list the synagogue(s) and the city where you previously had membership:

What draws you to Congregation Har Shalom?

Adult Applicant 2

Name

Date of Birth (mm/dd/yyyy)

Pronouns (he/she/they/etc.)

Best Phone Number

Second Phone Number

Occupation

Family Information

Children & Adult Children (please include names, gender and DOB:

Please list Congregants you are related to:

Yahrtzeits - we will remember the anniversary of the death of any of your family members if you include Name, Relationship and Date of Death

Anything else you'd like Har Shalom to know about you and/or your family?

Description

Please fill out this form and click submit. This will enable Har Shalom to learn how best to welcome and engage you, as well as mark personal milestones with you.
After completing this application, someone from Congregation Har Shalom will contact you by phone within a week.

Membership Application

Description

Please Fix the Following