This is the New Member Registration Form for households who were not active members of Shir Hadash Synagogue last year. After you fill out this form and submit payment, you will be a member of Shir Hadash Synagogue for this year!

Do NOT complete this form on your phone!

Feeling lost? Click on this link to our Membership Information Page, which contains useful information such as:

Links to all our forms
Help on understanding which forms you need to fill out
Descriptions of different kinds of information we collect in these forms
Information about payment plans and methods
Account Login Help
and more !

MEMBERSHIP CATEGORY

Please identify your membership category for demographic information only. Please refer to our Membership Information Page for help on which category to select.

* Membership Category

Please select your appropriate category

ADULT MEMBERS INFORMATION

Please fill out the following information for the adults in the household.

Adult #1

First Name

Adult # 2

First Name

Nickname Adult #1

Nickname Adult #2

Last Name Adult #1

Last Name Adult #2

Preferred Pronouns Adult #1

Preferred Pronouns Adult #2

Hebrew First Name Adult #1

Hebrew First Name Adult #2

Birthday Adult #1

Birthday Adult #2

Mobile Phone Adult #1

Please enter dashes

Mobile Phone Adult #2

Please enter dashes

Email Adult #1

Email Adult #2

Tradition Adult #1

In what tradition were you raised?

Tradition Adult #2

In what tradition were you raised?

Occupation Adult #1

Occupation Adult #2

Business Name Adult #1

Business Name Adult #2

Address Line 1

Home Address

Address Line 2

Additional Address Information

City

State

* Zip

Home Phone

Home Phone # Landlines only, please enter dashes.

Marital Status

Anniversary

if applicable

Emergency Contact Adult #1

Name and Phone

Emergency Contact Adult #2

Name and Phone

I have reviewed this information and it is currently correct. I understand that this information will be used for congregational communciations and will be published in the directory as listed here.

CHILDREN INFORMATION

Please enter your child(ren)'s information by clicking the small + sign below. Keep clicking the + sign until you have finished entering all of your children. Please refer to our Membership Information Page for maximum age limits before children need their own membership accounts.

Child First Name

Child last name

Nickname

Hebrew Name

Child Birthdate

Child Pronouns

Child Mobile Phone #

(Please insert dashes)
If none, leave blank

VOLUNTARY COMMITMENT FOR MEMBERSHIP

Please refer to our Membership Information Page for more information about our Voluntary Commitment program.

Enter Your Own Voluntary Membership Commitment Amount

Please enter total amount for the year.

You may select an installment plan on the payment page

BUILDING FUND

Please refer to our Information Membership Page for information about our Building Fund and your obligations in this area.

Building Fund Selection

$350 Building Fund$1960 I would like to pay my entire Building Fund Commitment*I was a member at another congregation and have fulfilled my obligations (additional information required).I have called the Office Administrator and worked out a different building fund amount for this year (fill in below)*If you choose to pay your Building Fund commitment all at once, you receive a 20% discount off the total of $2450 for a full payment of $1960.

Please list the names and locations of your prior religious organizations where you have completed your building fund obligations

Select Your Building Fund Donation

Please fill in the amount that you have already worked out with the Office Administrator.

Additional Building Fund Donation

I would like to make an additional donation to our Building Fund to make sure our repairs and upgrades can be properly executed.

RELIGIOUS SCHOOL AND MADRICHIM TUITION

Do you plan to enroll children in the Religious School (K-7) ?

Please select the total number of students you wish to enroll in Religious School this year (Grades K-7)

* Please enter your family's voluntary Religious School tuition below

This amount should include voluntary tuition for all students entering Grades K-7. The break-even amount per student this year is $1,539. Please refer to our Membership Information Page for details about Religious School Voluntary Tuition.

Do you plan to enroll children in the Madrichim program (8-12) ?

* Please select your family's total number of students you wish to enroll in the Madrachim program this year (Grades 8-12)

For additional information about our Religious School, the Madrichim Program, Madrichim Tuition, the Madrichim Application form, and help on which forms you need to fill out, please refer to our Membership Information Page.

SKILLS, INTERESTS, ACTIVITIES and COMMITTEES

The synagogue often finds itself in need of expertise and specialized skills sets beyond the realm of our small staff. Please refer to our Membership Information Page for more information about volunteering your skills and time.

Expertise Adult #1

Expertise Adult #2

Time Adult #1

Time Adult #2

THE FINISH

As a new member of Shir Hadash, I/we understand I/we am/are making a commitment to support the Jewish community. I/we understand that all financial commitments must be current, and that I/we must be a Member in Good Standing (according to the policies of Shir Hadash) in order to receive High Holy Day access and other synagogue services.

I/we further understand Shir Hadash depends upon this commitment and I/we pledge to fulfill my financial obligation on or before May 31, 2023. If I/we am/are unable to do so, I/we agree to contact the office to make alternative payment arrangements.

I/we hereby grant Shir Hadash Synagogue permission to use my/our likeness(es), as well as those of my/our children, in a photograph, video, or other digital media (“photo”) in any and/or all its publications, including web-based publications, without payment or other consideration, and without name identification. (You may opt out of this clause for your children by calling the office or indicating so on the Religious School Registration form.)

My/Our good faith commitment to fulfill this membership pledge during the required time period is represented by my/ our entering my/our name(s) below.

Total Amount Due

Includes voluntary commitment for membership, building funds. Includes voluntary tuition for religious school and Madrichim tuition when applicable. You may select an installment plan on the payment page. More details and help available on our Membership Information Page.

* Digital Signature

By typing your name in this box, you agree to the terms above.

Digital Signature

By typing your name in this box, you agree to the terms above.

* Your email

A copy of this form will be sent to you.

SUBMIT

New Member Registration 2022-2023

VOLUNTARY COMMITMENT FOR MEMBERSHIP