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Sponsored by: Congregation Dor Hadash
Sponsored by: Congregation Dor Hadash
Congregation Dor Hadash
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Membership Form
Please verify reCaptcha before submitting the form.
Welcome! Thank you for showing interest in joining Dor Hadash! We look forward to having you become a part of our community!
Before you begin this form, have you completed the
New Member Inquiry
form?
If so, please continue with this form! If not, please complete the New Member Inquiry form and we will get back to you as soon as possible!
Any questions or concerns? Email
membership@dorhadash.net
Adult 1
Last Name
First Name
Nickname
if applicable
Pronouns
e.g. he/him/his
Jewish
Is Jewish
Is not Jewish
Non-Jewish spouses and partners are always welcome to become members of Dor Hadash. However, for proper assignment of ritual tasks, Dor Hadash would like to know if someone is Jewish.
Date of Birth
Bar / Bat / B'nai Mitzvah Date
Torah Portion
Bereshit
Noach
Lech Lecha
Vayera
Chayei Sara
Toldot
Vayetzei
Vayishlach
Vayeshev
Miketz
Vayigash
Vayechi
Shemot
Vaera
Bo
Beshalach
Yitro
Mishpatim
Terumah
Tetzaveh
Ki Tisa
Vayakhel
Pekudei
Vayikra
Tzav
Shmini
Tazria
Metzora
Achrei Mot
Kedoshim
Emor
Behar
Bechukotai
Bamidbar
Nasso
Beha'alotcha
Sh'lach
Korach
Chukat
Balak
Pinchas
Matot
Masei
Devarim
Vaetchanan
Eikev
Re'eh
Shoftim
Ki Teitzei
Ki Tavo
Nitzavim
Vayeilech
Ha'Azinu
Vayakhel-Pekudei
Tazria-Metzora
Achrei Mot-Kedoshim
Behar-Bechukotai
Chukat-Balak
Matot-Masei
Nitzavim-Vayeilech
Vezot Haberakhah
Select One
Hebrew Name
Please use English transliterations
Parent 1 / Mother's Hebrew Name, if known (otherwise, English name)
Please use English transliterations
Parent 2 / Father's Hebrew Name, if known (otherwise, English name)
Please use English transliterations
Cell Phone
If applicable
Home Phone
If applicable
Work Phone
If applicable
Email Address
Accessibility Considerations and Accommodations
If applicable
Home Address
Street
City
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
Zip
Adult 2
Do you need to add a second adult?
No
Yes
Last Name
First Name
Nickname
if applicable
Pronouns
e.g. he/him/his
Jewish
Is Jewish
Is not Jewish
Non-Jewish spouses and partners are always welcome to become members of Dor Hadash. However, for proper assignment of ritual tasks, Dor Hadash would like to know if someone is Jewish.
Date of Birth
Bar / Bat / B'nai Mitzvah Date
Torah Portion
Bereshit
Noach
Lech Lecha
Vayera
Chayei Sara
Toldot
Vayetzei
Vayishlach
Vayeshev
Miketz
Vayigash
Vayechi
Shemot
Vaera
Bo
Beshalach
Yitro
Mishpatim
Terumah
Tetzaveh
Ki Tisa
Vayakhel
Pekudei
Vayikra
Tzav
Shmini
Tazria
Metzora
Achrei Mot
Kedoshim
Emor
Behar
Bechukotai
Bamidbar
Nasso
Beha'alotcha
Sh'lach
Korach
Chukat
Balak
Pinchas
Matot
Masei
Devarim
Vaetchanan
Eikev
Re'eh
Shoftim
Ki Teitzei
Ki Tavo
Nitzavim
Vayeilech
Ha'Azinu
Vayakhel-Pekudei
Tazria-Metzora
Achrei Mot-Kedoshim
Behar-Bechukotai
Chukat-Balak
Matot-Masei
Nitzavim-Vayeilech
Vezot Haberakhah
Select One
Hebrew Name
Please use English transliterations
Parent 1 / Mother's Hebrew Name, if known (otherwise, English name)
Please use English transliterations
Parent 2 / Father's Hebrew Name, if known (otherwise, English name)
Please use English transliterations
Cell Phone
If applicable
Work Phone
If applicable
Email Address
Accessibility Considerations and Accommodations
If applicable
Additional People
How many more people live in your home?
Please Select One
1
2
Person 1
Last Name
First Name
Nicknames
if applicable
Pronouns
e.g. he/him/his
Jewish
Is Jewish
Is not Jewish
Non-Jewish spouses and partners are always welcome to become members of Dor Hadash. However, for proper assignment of ritual tasks, Dor Hadash would like to know if someone is Jewish.
Date of Birth
Hebrew Name
Parent 1/Mother's Name. Please use English transliterations.
Son / Daughter / Child of
Parent 1/Mother's Name. Please use English transliterations.
Son / Daughter / Child of
Parent 2/Father's Name. Please use English transliterations.
Bar / Bat / B'nai Mitzvah Date
Torah Portion
Person 2
Last Name
First Name
Nicknames
if applicable
Pronouns
e.g. he/him/his
Jewish
Is Jewish
Is not Jewish
Non-Jewish spouses and partners are always welcome to become members of Dor Hadash. However, for proper assignment of ritual tasks, Dor Hadash would like to know if someone is Jewish.
Date of Birth
Hebrew Name
Parent 1/Mother's Name
Son / Daughter / Child of
Parent 1/Mother's Name
Son / Daughter / Child of
Parent 2/Father's Name
Bar / Bat / B'nai Mitzvah Date
Torah Portion
Accessibility Considerations and Accommodations
If applicable
Others Living in the Household
Are there any additional people in your household other than those listed above?
No
Yes
Life Cycle Events
Is there a Bar / Bat / B'nai Mitzvah planned within the next two years?
Please Select One
Yes
No
Is there an upcoming wedding, special anniversary, baby-naming, or other life event expected?
Yizkor
: Please list names of the departed to be remembered at Yizkor Services on Yom Kippur.
Yahrzeits
: Please include Yahrzeit information as follows: after each name, indicate date, month and year of death based on the English calendar. Please indicate if time of death was before or after sunset.
Where did you find out about Dor Hadash?
Select One
Friend
Family
Search Engine
Social Media
Tue, April 23 2024 15 Nisan 5784