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New Member Application
Please verify reCaptcha before submitting the form.
*
First Name
*
Last Name
Hebrew Name
*
Date of Birth. Please type date in this format:
Gender
Please choose one.
Male
Female
Nonbinary
Other
What is your preferred gender description?
What are your preferred pronouns?
*
Mailing Address
Address Line 2 (optional)
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
ZIP Code
Phone Number
*
Email Address
Regular access to email?
Please select one.
Yes, please send as much communication via email as possible.
No, I/we do not have access to email and require physical mailings when possible.
In order to minimize use of paper products, most of our member communications are via email. Please indicate whether you have regular access to email.
In which religious tradition were you raised?
Please choose one.
Reform
Conservative
Orthodox
Reconstructionist
Renewal
Non-practicing
Non-Jewish
Is this the first time you've become a member of a Jewish congregation?
Please choose one.
Yes
No
Of what other Jewish congregation(s) have you been a member? Please indicate name(s) and location(s) of previous/other congregation(s).
As a member of another congregation, in what programs, committees, or activities have you been involved?
Would you be interested in involvement in any of the following programs or committees? Check all that apply.
Audit Committee
Board of Trustees/Officers
Brotherhood
Budget Committee
Bylaws Committee
Caring Committee
Cemetery Committee
Challah Bakers
Congregation Albert Band
Family Promise
Finance Committee
Fundraising Committee
Green Team
Investment Committee
Israel C. Carmel Archive Committee
Library Committee
Membership Committee
Nominating Committee
Religious Practices Committee
Scholarship Committee
Security Committee
Shabbat Meditation
Sisterhood
Social Action Committee
Zamir (Adult Choir)
*
Which of these best describes you?
Please Select One
Single
Divorced
Widow/Widower
Partnered
Married
Spouse's First Name
Spouse's Last Name
Spouse's Hebrew Name
Spouse's Date of Birth. Please type date in this format:
When were you married? Please type date in this format:
Is your spouse also Jewish?
Please choose one.
Yes
No
Spouse's Gender
Please choose one.
Male
Female
Nonbinary
Other
What is your spouse's preferred gender description?
What are your spouse's preferred pronouns?
Partner First Name
Partner Last Name
Partner's Hebrew Name
Partner's Date of Birth. Please type date in this format:
Is your partner also Jewish?
Please choose one.
Yes
No
*
Partner's Gender
Please choose one.
Male
Female
Nonbinary
Other
What is your partner's preferred gender description?
What are your partner's preferred pronouns?
*
Do you have children under the age of 18?
Please choose one.
Yes
No
Child 1 First Name
Child 1 Last name
Child 1 Date of Birth. Please type date in this format:
Child 1 Gender
Please choose one.
Male
Female
Nonbinary
Other
What is this child's preferred gender description?
What are this child's preferred pronouns?
Child 1 Grade in Secular School
Please choose one.
Too young for secular school
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Does this child have previous religious school experience?
Please choose one.
Yes
No
Is this child a bar/bat mitzvah?
Please choose one.
Yes
No
Has this child completed confirmation?
Please choose one.
Yes
No
Will this child be interested in Eitzim Hub, our educational community for children of all ages?
Please choose one.
Yes
No
Do you have more children under 18?
Please choose one.
Yes
No
Child 2 First Name
Child 2 Last Name
Child 2 Date of Birth. Please type date in this format:
Child 2 Gender
Please choose one.
Male
Female
Nonbinary
Other
What is this child's preferred gender description?
What are this child's preferred pronouns?
Child 2 Grade in Secular School
Please choose one.
Too young for secular school
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Does this child have previous religious school experience?
Please choose one.
Yes
No
Is this child a bar/bat mitzvah?
Please choose one.
Yes
No
Has this child completed confirmation?
Please choose one.
Yes
No
Will this child be interested in Eitzim Hub, our educational community for children of all ages?
Please choose one.
Yes
No
Do you have more children under 18?
Please choose one.
Yes
No
Child 3 First Name
Child 3 Last Name
Child 3 Date of Birth. Please type date in this format:
Child 3 Gender
Please choose one.
Male
Female
Nonbinary
Other
What is this child's preferred gender description?
What are this child's preferred pronouns?
Child 3 Grade in Secular School
Please choose one.
Too young for secular school
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Does this child have previous religious school experience?
Please choose one.
Yes
No
Is this child a bar/bat mitzvah?
Please choose one.
Yes
No
Has this child completed confirmation?
Please choose one.
Yes
No
Will this child be interested in Eitzim Hub, our educational community for children of all ages?
Please choose one.
Yes
No
Do you have more children under 18?
Please choose one.
Yes
No
Child 4 First Name
Child 4 Last Name
Child 4 Date of Birth. Please type date in this format:
Child 4 Gender
Please choose one.
Male
Female
Nonbinary
Other
What is this child's preferred gender description?
What are this child's preferred pronouns?
Child 4 Grade in Secular School
Please choose one.
Too young for secular school
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Does this child have previous religious school experience?
Please choose one.
Yes
No
Is this child a bar/bat mitzvah?
Please choose one.
Yes
No
Has this child completed confirmation?
Please choose one.
Yes
No
Will this child be interested in Eitzim Hub, our educational community for children of all ages?
Please choose one.
Yes
No
Do you have more children under 18?
Please choose one.
Yes
No
Mazal tov!
We will contact you later to collect information on additional children.
Do you have adult children? (Please note that adult children are not included in family membership.)
Please choose one.
Yes
No
Please list the names and dates of birth of your adult children.
Do you have grandchildren?
Please choose one.
Yes.
No.
Please list the names and dates of birth of your grandchild(ren).
We look forward to getting to know you! To get us started, please let us know a little bit about you. Where were you born? Where have you lived? What do you do for a living? Are you retired? Share as much or as little as you like.
What do you hope to experience as a member of Congregation Albert?
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Please check this box after reading our Code of Ethics.
Please check this box after reading our Code of Ethics.
Click here to read our Code of Ethics.
*
Please check this box after reading the following:
Please check this box after reading the following:
Membership at Congregation Albert requires an annual pledge. Each member pledges in order to sustain temple operations (e.g., programming, music, education, youth, salaries, repair and maintenance, insurance, and utilities). Congregation Albert is committed to a Fair Share Pledge Policy, expecting each member to contribute based on financial ability. This policy recognizes we have a collective responsibility to pledge according to our individual means. The suggested pledge amount is based on 2% of your adjusted gross income, which is your annual income before tax deductions. No current or prospective member is denied membership because of financial hardship.
*
Please check this box after reading the following:
Please check this box after reading the following:
Upon submission of this New Member Application, you will receive an email with a link to our New Member Financial Commitment form. Your initial annual financial commitment will be prorated according to when your membership application was received.
*
Please check this box after reading the following:
Please check this box after reading the following:
Annual financial commitments are most often paid in monthly increments. For this, it is recommended that members establish automatic monthly payments by contacting our accounting specialist. Financial commitments may also be made in one annual lump sum, or in any other arrangement which works for you. However, the total annual financial commitment is due no later than June 30 of every year. Nonpayment will result in loss of status as a member in good standing.
Nonpayment causes serious consequences for Congregation Albert.
*
Please check this box after reading the following:
Please check this box after reading the following:
Your annual financial commitment must be updated annually (often in May or June). The amounts pledged by members directs our annual budget.
Members who do not update their annual financial commitment risk losing status as members in good standing.
*
Please check this box after reading the following:
Please check this box after reading the following:
New membership at Congregation Albert requires a contribution to the Building Fund. An exemption from this requirement can be obtained by providing proof of contribution to another Union for Reform Judaism (URJ) synagogue's Building Fund within the past 10 years.
Mon, December 30 2024 29 Kislev 5785
