Temple Beth Avodah Membership Form

* Adult 1 First Name

* Adult 1 Last Name

* Adult 1 Email

* Adult 1 Cell Phone

* Adult 1 Birthdate

Adult 1 Occupation

Adult 1 Business Name

Adult 1 Business Phone

Adult 1 Religious Background

Adult 1 Gender

Adult 1 Preferred Prounouns

Adult 2 First Name

Adult 2 Last Name

Adult 2 Email

Adult 2 Cell Phone

Adult 2 Birthdate

Adult 2 Occupation

Adult 2 Business Name

Adult 2 Business Phone

Adult 2 Religious Background

Adult 2 Gender

Adult 2 Preferred Prounouns

* Home Address Line 1

Home Address Line 2

* City

* State

* Zip Code

Home Phone (if applicable)

* Marital Status

Wedding Date

Child's First Name

Child's Last Name

Child's Birthdate

Child's Gender

Child's Preferred Pronouns

Child's Hebrew Name (phonetically written out)

Child's School Grade as of September 2024

Please list children through age 25

Name of School Child will be attending September 2024

I Would Like to Enroll My Child in Grades K-12 Religious School

Please click the plus sign to add information for all children in the household through age 25

Child's First Name

Child's Last Name

Child's Birthdate

Child's Gender

Child's Preferred Pronouns

Child's Hebrew Name (phonetically written out)

Child's Grade in School as of September 2024

Name of School Child will be attending September 2024

I Will Be Enrolling My Child in K-12 Religious School

Please list relatives who are members of the congregation and their relationship to you.

Relative

Relationship

Please click the plus sign to add more names.

Name

Relationship

Please list information for Yahrzeit notifications below. Click the plus sign to add additional names.

I would like Yahrzeits to be Memorialized on:

Name

Last Name

Mourner

Please let us know which adult in the household is the mourner

Relationship To Mourner

Date of Death

Before or After Sundown?

Click on the plus sign to enter additional names

First Name

Last Name

Mourner

Please let us know which adult inthe household is the mourner

Relationship To Mourner

Date of Death

Before or After Sundown?

Please share a little more about yourself. How did you learn about TBA? What interests you in being a part of our community? Is there anything else you would like us to know?

Prior Temple Affiliation

City, State

Years Belonged

In your first year of membership you are not required to make a financial contribution to the Member Commitment (fees for school and B'nai Mitzvah still apply). Some new members still elect to make a contribution in year 1 as it is at your discrertion. Would you like to make a contribution this year?

We are so grateful that you have chosen to be a part of the TBA family. We'll be in touch further once we have set up your account. In the meantime, feel free to reach out to our Executive Director Becky Oliver with any questions.

We look forward to seeing you at TBA soon!

Thu, September 12 2024
9 Elul 5784

Thu, September 12 2024 9 Elul 5784