B'ShERT Membership Application

Household Information
Please let us know how to contact you and where you are!

* Address 1

Address Line 2

* City

* State

* Zip

* Home Phone

If you do not have a home phone number, please enter the primary cell phone number for your family.

Married, Partnered, Single?

Wedding Anniversary Date, if married

* Have you (or your partner/spouse) been recently affiliated with any other synagogues?

If you are a past member of B'ShERT or one of its predecessor synagogues (PTBAS, TBE, or others), please select Yes and write in the years of your previous membership.

* Name of Synagogue

* Location of Synagogue

* Date(s) of previous membership(s)

* Do you (or your partner/spouse) have friends or relatives who are current or past B'ShERT members?

* Name

* What is your relationship to this person?

Name

What is your relationship to this person?

Name

What is your relationship to this person?

Adult 1 (Primary) Information

* First Name

* Last Name

* Email

Cell Phone

Text messages?

YesNoMay we send you text messages for urgent updates?

B'ShERT Broadcast

Yes, to my home phoneYes, to my mobile phoneNo thanksOne of the ways we alert members to urgent Temple news, events, and the weekly service schedule is through our automated phone system. Would you like to receive these messages? (You can change your preference at any time by contacting the Temple office.)

* Date of Birth

Gender

Pronouns

Occupation

Business Name or Employer

Business Address

Business Phone

If there's anything you would like to share regarding your or your family's faith tradition, please let us know.

Additional Family Members

* Is there another adult in your household?

* Do you have children or young adults in your household (18 and under)?

* Do you have children over the age of 18?

Adult 2 Information

* First Name

* Last Name

* Email

Cell Phone

Text messages?

YesNoMay we send you text messages for urgent updates?

Date of Birth

Gender

Pronouns

Occupation

Business Name or Employer

Child 1 Information (Under 18)

Child 1 First Name

Child 1 Last Name

* Child 1 Gender

* Child 1 Pronouns

Child 1 Date of Birth

What school grade is your child in (as of September 2022)?

* Do you want to enroll your child in the Religious School?

* Has your child had (or will your child have) a Bar/Bat/B'Nai Mitzvah?

Child 1 Hebrew Name

* What school does your child attend?

* Does your child live at home with you full time?

* Do you have a second child under the age of 18?

Child 2 Information (Under 18)

* Child 2 First Name

* Child 2 Last Name

* Child 2 Gender

* Child 2 Pronouns

Child 2 Date of Birth

What school grade is your child in (as of September 2022)?

* Will your child attend Religious School?

* Has your child had (or will your child have) a Bar/Bat/B'Nai Mitzvah?

Child 2 Hebrew Name

* What school does your child attend?

* Does your child live at home with you full time?

Do you have a third child under the age of 18?

Child 3 Information (Under 18)

* Child 3 First Name

* Child 3 Last Name

* Child 3 Gender

* Child 3 Pronouns

Child 3 Date of Birth

What is your child's grade as of September 2022?

* Will your child attend Religious School?

* Has your child had (or will your child have) a Bar/Bat/B'nai Mitzvah?

Child 3 Hebrew Name

* What school does your child attend?

* Does your child live at home with you full time?

Child1 Information (Over 18)

* Child 1 First Name

* Child 1 Last Name

* Child 1 Gender

* Child 1 Pronouns

* My child is:

* Does your child live at home with you full-time?

* Do you have a second child over the age of 18?

Child 2 Information (Over 18)

* Child 2 First Name

* Child 2 Last Name

* Child 2 Gender

* Child 2 Pronouns

* My child is:

* Does your child live at home with you full-time?

* Do you have a third child over the age of 18?

Child 3 (Over 18) Information

* Child 3 First Name

* Child 3 Last Name

* Child 3 Gender

* Child 3 Pronouns

* My child is:

* Does your child live at home with you full-time?

Yahrzeit Information
Once your membership application is approved, you may add Yahrzeits for family & friends via our portal at bshert.shulcloud.com.

Additional Information

* Please share what factors led to your interest in B'ShERT, or how you heard about us!

Is there anything else you would like to share with us (such as special interests or areas of expertise)?

Directory

YesNoMay we include your family in our Congregational Directory?

Hebrew Names

If you know the Hebrew names of your family members, please add them here.

Lay Service Leader?

YesMaybeNoIf you are interested in being trained as a lay leader for services, please let us know.

Membership Category and Payment Information
Membership categories vary depending on the number of adults in the household and the age of the oldest spouse/partner.

Family Membership:

(1) or (2) adults + children under 23 living at home
Family tickets for High Holiday services

Single Membership:

(1) adult
(1) ticket for High Holiday services

Under 35 Family Membership:

2 adults BOTH under 35 years old
Includes children under 23 living at home
(2) tickets for High Holiday services

Under 35 Single Membership:

(1) adult under age 35
(1) ticket for High Holiday services

Memberships also include a subscription to the B'ShERT Newsletter, a listing in the Temple Member Directory (unless declined), voting privileges at Congregational Meetings, support from Temple clergy, ability to purchase a cemetery plot at lower cost, and other privileges as set forth in the B'ShERT bylaws.

Half the annual dues, Building Fund Charges, and Religious School tuition (if applicable) are due upon acceptance of this application. If you wish to make other payment arrangements, please contact the office to schedule a conversation with the Temple president or treasurer.

Associate Membership ("Zoom membership") is available only to individuals or families who do not live in the five boroughs of New York City. Please contact the office prior to applying for Associate Membership to verify eligibility. Associate Membership excludes voting rights and certain other rights of full Membership.

* In which membership category do you (and your partner/spouse) belong?

* Please select the method of payment you will be using to take care of your membership dues. Once your application is submitted and reviewed, our office will reach out to help you finalize your membership account.

Declaration of Membership Intent

Adult 1Adult 2 (if multiple adults in household)I/We hereby apply for membership to Beth Shalom v’Emeth Reform Temple and I/we will promptly contribute one half of our annual dues & other obligations when our membership is approved. I/We will pay the remaining half of our financial obligation within six months. I/We agree to abide by all Bylaws, Rules and Policies affecting Temple members and, unless other financial arrangements have been made, agree to stay current with the financial obligations as documented in this membership form or in other programs with B'ShERT.

Please check the box for each adult in your household to indicate your agreement.

Upload a photo!

Please upload a recent family photo here. We can accept JPEG or PNG files. This photo will not be shared publicly; it is just for our rabbi and officers to be able to see and start to know our new members. Thank you!

You can upload a maximum of 1 files.

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