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HOUSEHOLD INFORMATION

Primary Street Address

(Apt., Suite, etc.)

City

State

Zip Code

Home Phone Number

Member 1 Information

Member 2 Information

Member 1 Title Preference

Member 2 Title Preference

Member 1 First Name

Member 2 First Name

Member 1 Last Name

Member 2 Last Name

Gender (optional)

Member 1 Birthday

Member 2 Birthday

Member 1 Cell Phone Number

Member 2 Cell Phone Number

Member 1 Email

Member 2 Email

Personal Information

Wedding Anniversary

Member 1 Occupation

Member 2 Occupation

RELIGIOUS HISTORY

Name of Previous Congregation as an Adult

Previously Paid Building Fund Fee

yesnounsure

Information About Child(ren) - Please complete the following information for all children including college

First Child

First Name

Last Name

Hebrew Name (if known)

Birthday

Gender

MaleFemale

Plan on Attending Religious School in coming year?

yesnounsure

School Grade at time of application

Name of Current School Attending

Second Child

Second Child First Name

Second Child Last Name

Hebrew Name (if known)

Second Child Birthday

Second Child Gender

MaleFemale

Second Child Plan on Attending Religious School in the Coming Year?

yesnoUnsure

Second Child School Grade at time of application

Second Child Name of Current School Attending

Third Child

Third Child First Name

Third Child Last Name

Hebrew Name (if known)

Birthday

Gender

MaleFemale

Plan on Attending Religious School in the Coming Year?

YesNoUnsure

School Grade at time of application

Name of Current School Attending

REMEMBRANCE OF LOVED ONES - YAHRZEIT DATES

Yahrzeits mark the anniversary date of the death of loved ones. At Shabbat services, we acknowledge those we remember by reading their names when we recite the Mourner’s Kaddish.

Please provide date of passing whose loved ones you wish to commemorate as well as your preference by English or Hebrew date. We will make any necessary conversions and inform you of the Yahrzeit date each year.
We are asking you to please provide the phonetic pronunciation of the names so we can make every effort to read them correctly.
(Please use additional paper for others you would like to remember.)

Full Name of Loved One

Related to:

Member 1Member 2

Relationship

Date of Passing

Yahrzeit Observance

EnglishHebrew

Full Name of Loved One

Related to:

Member 1Member 2

Relationship

Date of Passing

Yahrzeit Observance:

EnglishHebrew

Full Name of Loved One

Related to:

Member 1Member 2

Relationship

Date of Passing

Yahrzeit Observance:

English DateHebrew Date

WAYS TO CONNECT WITH TEMPLE EMANU-EL

Our strength comes from our members. As you become part of the Temple Emanu-El Community,

we encourage you to participate and enjoy in our diverse activities that help make our vibrant

Temple life possible.

ADULT EDUCATION/LEARNING

Member 1Member 2Classes, films, discussion groups, speakers, etc.

ADULT SOCIAL ACTIVITES

Member 1Member 2Dining, theatre-going, and events with other members in our community

ALUMNI CONNECTION

Member 1Member 2Outreach to our college-age children

FESTIVAL CELEBRATIONS

Member 1Member 2Programs/parties/community dinners for Chanukah, Purim and other holidays

INTERFAITH ACTIVITIES

Member 1Member 2Outreach for members new to Judaism or interfaith family members

SOCIAL ACTION/TIKKUM OLAM

Member 1Member 2Opportunities to participate in repairing the world "tikkun olam" (Mitzvah Day, Food Drives and more)

BROTHERHOOD

Member 1Member 2Men working together to sponsor monthly breakfasts with guest speakers and other programming

SISTERHOOD

Member 1Member 2Women involved in worship, education, community service and socializing

FINANCE

Member 1Member 2Budget and long-range financial planning

DEVELOPMENT

Member 1Member 2Full range of activities to help insure the Temple's wellbeing (fundraising)

MARKETING/PR

Member 1Member 2Help "spread the word" about our wonderful congregation

MEMORIAL PARK

Member 1Member 2Help oversee the Temple Emanu-El Memorial Park

JEWISH MUSIC NEIGHBORHOOD

Member 1Member 2Sing, play music, and lead services as a group

YOUNG PROFESSIONALS

Member 1Member 2Mostly social activities for those in their 20's and 30's

MEMBERSHIP

Member 1Member 2Welcoming new members and hosting activities to grow and maintain membership

EVENT SUPPORT

Member 1Member 2Help with special events such as concerts, comedy nights, dinners and more

YOUNG FAMILIES NEIGHBORHOOD

Member 1Member 2Participate in social and religious activities for children ages 7 and under

YOUTH GROUP

Member 1Member 2Support our Youth Group and its many activities

PHOTOGRAPHY

Member 1Member 2Take photos of Temple events

CARING COMMUNITY

Member 1Member 2Support our members in their times of need, help with driving people to Shabbat services or personal appointments

SENIOR CONNECTION NEIGHBORHOOD

Member 1Member 2Create and participate in activities for seniors

FACILITIES SUPPORT

Member 1Member 2Help to oversee maintenance of the Temple building and grounds

RELIGIOUS SCHOOL

Member 1Member 2Provide oversight and support for our Pre-K through grade 12 religious school

TECHNOLOGY

Member 1Member 2Participate in all aspects of technological growth

OTHER AREAS OF INTEREST

Name(s) of relatives that are current members of Temple Emanu-El

Please share with us any other information that will help us be sensitive to your needs as part of our community (e.g. interfaith issues, unique family situations):

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