Beth Shalom of Whittier 14564 Hawes Street Whittier, CA 90604   Parking - 14545 Mulberry Drive, 1.562.941.8744  Email Us

  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