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Personal Information
Member 1
Member 2
Click on month, date, year to type in change; or click on arrow at right of box to select from calendar.
Address Information
Billing Address (if different)
Family Information
Children (please complete as it applies to each of your children residing with you)
1st Child
2nd Child
3rd Child
4th Child
Adult Children (25 years or older) Not Residing With You
Other Adults in Your Household
1st Adult
2nd Adult
3rd Adult
Yahrzeit Information
Please list the names of loved ones for whom you wish Yahrzeit notices sent
Religious Background (Optional)
Miscellaneous Information
Agreement
The undersigned hereby apply for membership in Temple Shaari Emeth and agree to comply with the rules and regulations of the Temple, and to pay and be responsible for the dues and full building assessments as established by the Board of Trustees. It is understood that the full unpaid building fund assessment is due upon resignation, and resignations must be submitted in writing. B'nai Mitzvah dates are assigned and confirmed at the completion of 4th grade. It is further understood that any child attending our Religious School shall continue attending after Bar/Bat Mitzvah through Confirmation, which occurs at the end of 10th grade.
Writing your name here is the equivalent of your signature. You are agreeing to the above as conditions of membership.