membership

We are delighted that you are interested in joining our sacred community.  Just a few questions before you’re officially a part of the Rodef Shalom family...

Member A
Name *
Name
Abbreviated or Nickname
Birthday *
Birthday
Cell Phone
Cell Phone
Work Phone
Work Phone
Is it different now?
Emergency Contact
Emergency Contact
Member B
(If more than 1 adult in the household)
Name
Name
Abbreviated or Nickname
Birthday
Birthday
Cell Phone
Cell Phone
Work Phone
Work Phone
Is it different now?
Emergency Contact
Emergency Contact
Household
Anniversary Date
Anniversary Date
Home Address *
Home Address
Home Phone
Home Phone
About the Kids
(If Applicable)
Child One
Child One
Cell Phone
Cell Phone
Birthday
Birthday
Bar/Bat Mitzvah Date
Bar/Bat Mitzvah Date
Confirmation Date
Confirmation Date
Child Two
Child Two
Cell Phone
Cell Phone
Birthday
Birthday
Bar/Bat Mitzvah Date
Bar/Bat Mitzvah Date
Confirmation Date
Confirmation Date
Child Three
Child Three
Cell Phone
Cell Phone
Birthday
Birthday
Bar/Bat Mitzvah Date
Bar/Bat Mitzvah Date
Confirmation Date
Confirmation Date
Previous Congregational Affiliation
Let's make it official!
Electronic Signature *
Electronic Signature
I (we) hereby apply for membership at Rodef Shalom Congregation. As I agree to abide by the by-laws, rules, and regulations of the Congregation, include the timely payment of contributions, and any other charges as approved by the Board of Trustees. I (we) understand that failure to do so may result in suspension or termination of membership, but not the obligation to pay any previously incurred dues or fees. All resignations from the Congregation must be in writing.