Beth Shalom of Whittier 6726 Washington Ave, Whittier, CA 1.562.941.8744 Email Us
Beth Shalom of Whittier
Progressive Conservative Judaism
Membership
Beth Shalom of Whittier
14564 Hawes Street, Whittier, CA 90604
Office: 562-941-8744 ∙ FAX: 562-941-0449
MEMBERSHIP APPLICATION/RENEWAL
2017-2018 - 5777-5778
PLEASE PRINT
1. Last Name ________________________First ______________ Hebrew Name_________________________ 2. Last Name ________________________First ______________ Hebrew Name_________________________ Address ____________________________________ City ____________________ Zip _________________ Phone: Home (___) ______ - _________
Work (___) ______ - _________ Cell: (___) ______ - ________
1. E-mail Address: _______________ 2. E-mail Address: ________________ Cohen 1__ 2___ Levite 1___2___
Birth Date: 1.____/_____/_19____ Birth Date 2 ._____/_____/_19____ Anniversary Date ____/_____/_____ School-Age Children: Name: ______________________Hebrew Name ________________ DOB____
Public School Grade ______ Name: ______________________Hebrew Name ________________ DOB_____ Public School Grade ______ Name: ______________________Hebrew Name ________________ DOB_____ Public School Grade ______ Name: ______________________Hebrew Name ________________ DOB_____ Public School Grade ______
Please send me Yahrzeit Notices for: ______________________________________D.O.D._________________Relationship___________________ ______________________________________D.O.D._________________Relationship___________________ ______________________________________D.O.D._________________Relationship___________________ ______________________________________D.O.D._________________Relationship___________________ I/We request membership at Beth Shalom of Whittier in the following category:
Membership includes High Holidays and all Life Cycle Events Membership may be paid in 10 monthly billings.
_____ Family Membership $1,025.00 (School tuition included)
_____ Couple Membership $ 700.00
_____ Single Membership $ 525.00
_____ Student Membership $ 300.00
_____ Associate Membership $ 150.00 (Must be full member at another synagogue. No voting privileges)
Your membership is enriched when you participate directly in the various activities of the Congregation. Please list and/or select your special volunteer interests here.
Bingo ____ Fund Raising ____ Serving on the Board ____ House and Grounds ____ Band/Choir
Other (Specify) _________________________
Click here to view our fee schedule