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New Member Application Form
Please verify reCaptcha before submitting the form.
Adult 1 - Title
Adult 1 - First Name
Adult 1 - Last Name
Adult 1 - Nick Name
Adult 1 - Gender
N/A or Unknown
Male
Female
Adult 1 - Date of Birth
Adult 1 - Hebrew Name
Adult 1 - Fathers Hebrew Name
Adult 1 - Mothers Hebrew Name
Adult 1 - Cell Phone
Adult 1 - Email Address
Adult 1 - Marital Status
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Single
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Committed Partner
Adult 1 - Anniversary date, if applicable
Is Adult 1 Jewish?
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No
Adult 1 - Occupation
Adult 1 - Full time/Part time/Retired:
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Adult 1 - Employer
Adult 1 - Home Mailing Address
Adult 1 - City
Adult 1 - State
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Adult 1 - Zip Code
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Adult B'nei Mitzvah
Adult Choir
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Ushering - High Holy Days
Ushering - Shabbat Services
Ways and Means Committee
Youth Activities Committee
Adult 1 - Are there any other areas of interest not mentioned above?
Adult 1 - Have you ever been in a position of leadership? If so, please explain.
Adult 1 - Please describe any special skills or talents:
Is there a second adult applying for membership?
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Adult 2 - Title
Adult 2 - First Name
Adult 2 - Last Name
Adult 2 - Nick Name
Adult 2 - Gender
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Male
Female
Adult 2 - Date of Birth
Adult 2 - Hebrew Name
Adult 2 - Fathers Hebrew Name
Adult 2 - Mothers Hebrew Name
Adult 2 - Cell Phone
Adult 2 - Email Address
Adult 2 - Marital Status
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Single
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Committed Partner
Is Adult 2 Jewish?
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No
Adult 2 - Occupation
Adult 2 - Full time/Part time/Retired:
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Adult 2 - Employer
*
Does Adult 2 live at the same address?
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Adult 2 - Home Mailing Address
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Adult 2 - State
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Adult 2 - Zip Code
Adult 2 - Home Phone
Adult B'nei Mitzvah
Adult Choir
Adult Education
Building and Grounds
Children's Choir
Early Childhood Education Volunteer
Gift Shop
Interfaith Friendship Initiatives
Israel Matters
Library Committee
Men's Club
Office Volunteer
Religious School Volunteer
Retreats
Ritual Committee
Sisterhood
Small Groups
Social Action Initiatives
Ushering - High Holy Days
Ushering - Shabbat Services
Ways and Means Committee
Youth Activities Committee
Adult 2 - Are there any other areas of interest not mentioned above?
Adult 2 - Have you ever been in a position of leadership? If so, please explain.
Adult 2 - Please describe any special skills or talents:
Mail will be addressed to Mr. & Mrs.
unless requested otherwise.
Please address our mail as follows:
Would like to list an additional address?
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*
How many children live in the family home?
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Child 1 - First Name
Child 1 - Last Name
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Child 1 - Hebrew Name in English
Child 1 - Gender
N/A or Unknown
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Child 1 - Date of Birth
Child 1 - Age
Child 1 - Grade in Secular School
Child 1 - Secular School Name
Child 1 - E.C.C at Temple Beth El
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Child 1 - Religious/Hebrew School
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Has Child 1 had a bar/bat mitzvah?
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Child 1 - Bar/Bat Mitzvah Date
Child 1 - Youth Group
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Put me on Mailing List
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Child 1 - Post High School Living at Home
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Child 1 - College Student
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Child 2 - First Name
Child 2 - Last Name
Child 2 - Nick Name
Child 2 - Hebrew Name
Child 2 - Gender
N/A or Unknown
Male
Female
Child 2 - Date of Birth
Child 2 - Age
Child 2 - Grade in Secular School
Child 2 - Secular School Name
Child 2 - E.C.C at Temple Beth El
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Now attending
Has attended
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Child 2 - Religious/Hebrew School
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Now attending
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Has Child 2 had a bar/bat mitzvah?
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Child 2 - Bar/Bat Mitzvah Date
Child 2 - Youth Group
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Put me on Mailing List
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Child 2 - Post High School Living at Home
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Child 2 - College Student
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Child 3 - First Name
Child 3 - Last Name
Child 3 - Nick Name
Child 3 - Hebrew Name
Child 3 - Gender
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Child 3 - Date of Birth
Child 3 - Age
Child 3 - Grade in Secular School
Child 3 - Secular School Name
Child 3 - E.C.C at Temple Beth El
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Child 3 - Religious/Hebrew School
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Has Child 3 had a bar/bat mitzvah?
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Child 3 - Bar/Bat Mitzvah Date
Child 3 - Youth Group
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Put me on Mailing List
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Child 3 - Post High School Living at Home
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No
Child 3 - College Student
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Child 4 - First Name
Child 4 - Last Name
Child 4 - Nick Name
Child 4 - Hebrew Name
Child 4 - Gender
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Child 4 - Date of Birth
Child 4 - Age
Child 4 - Grade in Secular School
Child 4 - Secular School Name
Child 4 - E.C.C at Temple Beth El
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Now attending
Has attended
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Child 4 - Religious/Hebrew School
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Now attending
Has attended
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Has Child 4 had a bar/bat mitzvah?
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No
Child 4 - Bar/Bat Mitzvah Date
Child 4 - Youth Group
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Put me on Mailing List
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Child 4 - Post High School Living at Home
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No
Child 4 - College Student
Please Select One
Yes
No
*
How many children over the age of 18, not living with you, do you have?
Please Select One
None
One older child
Two older children
Three older children
Child 1 - Title
Child 1 - First Name
Child 1 - Last Name
Child 1 - Birth Date
Child 1 - Last Name of Spouse, if married
Child 1 - Title of Spouse
Child 1 - Number of Children
Child 1 - Ages of Children
Child 1 - Address
Child 1 - City
Child 1 - State
--Select State--
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Georgia
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Iowa
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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
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Puerto Rico
Rhode Island
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South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Child 1 - Zip Code
Child 2 - Title
Child 2 - First Name
Child 2 - Last Name
Child 2 - Birth Date
Child 2 - Last Name of Spouse, if married
Child 2 - Title of Spouse
Child 2 - Number of Children
Child 2 - Ages of Children
Child 2 - Address
Child 2 - City
Child 2 - State
--Select State--
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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
Child 2 - Zip Code
Child 3 - Title
Child 3 - First Name
Child 3 - Last Name
Child 3 - Birth Date
Child 3 - Last Name of Spouse, if married
Child 3 - Title of Spouse
Child 3 - Number of Children
Child 3 - Ages of Children
Child 3 - Address
Child 3 - City
Child 3 - 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
Child 3 - Zip Code
The names of your deceased loved ones will be read in synagogue the Friday evening before the Yahrzeit Date (anniversary of death). Unsure of the date? Choose a date on which to remember your loved one.
*
How many yahrzeits would you like to observe?
Please Select One
None
One yahrzeit
Two yahrzeits
Three yahrzeits
Four yahrzeits
Deceased Name
Relationship
To whom?
Please Select One
Adult 1
Adult 2
Date of Death
Hebrew/English Observance
Please Select One
Hebrew Observance
English Observance
Deceased Name
Relationship
To whom?
Please Select One
Adult 1
Adult 2
Date of Death
Hebrew/English Observance
Please Select One
Hebrew Observance
English Observance
Deceased Name
Relationship
To whom?
Please Select One
Adult 1
Adult 2
Date of Death
Hebrew/English Observance
Please Select One
Hebrew Observance
English Observance
Deceased Name
Relationship
To whom?
Please Select One
Adult 1
Adult 2
Date of Death
Hebrew/English Observance
Please Select One
Hebrew Observance
English Observance
Temple Beth El make a special effort to address the diversity of congregants' needs in developing programs. Please complete the information below to assist us in learning more about your family.
Are you an Interfaith Family?
Please Select One
Yes
No
*
This household consists of:
Please Select One
Husband and Wife
Two adults other than Husband and Wife
Single Adult
Anniversary date, if appicable
Does anyone in the household have physical limitations which the temple's facilities might better accommodate?
Please Select One
Yes
No
What type of limitations:
Vision
Hearing
Mobility
Other
Please use the space below to indicate any other information you would like us to know.
*
Do you own cemetery property?
Please Select One
Yes
No
*
Cemetery Location
Please Select One
Yes
No
*
No, please have the cemetery representative contact me
No, please have the cemetery representative contact me
How did you hear about Temple Beth El?
Were you referred to Temple Beth El? If so, by whom?
Name, City and State of previous congregation
Year you left that congregation
Do you have any outstanding financial obligations to that congregation?
Temple Beth El of South Orange County and related organizations may use pictures of members and their child(ren) in TBESOC's promotional materials, including both printed and electronic media.
Our synagogue is alive every day of the week with activities that touch the hearts and minds of members of all ages. Our broad range of activities, programs, and services create many avenues for each of us to become engaged in out synagogue life and to develop strong relationships with others in our Temple Beth El Community. In all the ways you choose to take part in our community - practicing in prayer and study, volunteering in social action programs, attending High Holy Day services, celebrating simchas - your generous financial support is a key ingredient in our recipe for success.
Annual contributions are a gift that we each ake to help keep the doors open and programming running. Each year, we will ask you to determine your annual, tax deductible contribution to our Temple community, based on your ability to assume a fair-share of our operating budget. For our most recent fiscal year, the cost to operate our synagogue averaged $4,500 per member family. (This includes contributions towards security.) We hope you take this into consideration when determining how much you can contribute to maintaining our community.
In support of our spiritual home and in recognition of the Brit/Covenant we undertake as members, I/We hereby pledge to Temple Beth El my/our Annual Contribution of:
Members contributing at or above the Sustainer Level ($4,500/yea) will be recognized with the congregation
I/We prefer to remain anonymous.
I/We prefer to remain anonymous.
Upon submission of this form at the bottom of the page you will be taken to our online payment page where you will be able to pay in full or setup a recurring payment plan via credit card of e-check/ACH. Payment may also be made by check. I prefer to pay by:
Please Select One
Credit Card or e-check/ACH
I will mail a check.
People Helping People - Help ensure no one is denied membership due to their financial circumstances:
Please enter an amount above
MIRSKY Temple Beth El Religious School Scholarship Fund - Help ensure no child is denied a Jewish Education at Temple Beth El;
Please enter an amount above.
BE Sisters Annual Membership
Please Select One
Please sign me up
No thanks
$36 annual fee, due immediately by credit card or e-check.
Men's Club Annual Membership
Please Select One
Please sign me up
No thanks
$36 annual fee, due immediately by credit card or e-check.
Temple Beth El is a community for us now, AND for generations to come. Continue the legacy of a Jewish community here in South Orange County by remembering Temple Beth El in your Will or other Estate Plans. Leaving a gift after your lifetime supports a cause that has been important in each of our lives. We are happy to provide information about dozens of ways to leave a Jewish legacy, at every economic level. Please
click here
for more information.
Total Commitment
Mon, May 16 2022 15 Iyyar 5782