Membership Form - Form - Congregation Dor Hadash

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Sponsored by: Congregation Dor Hadash

Sponsored by: Congregation Dor Hadash

Congregation Dor Hadash

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Adult 1

Last Name

First Name

Nickname

if applicable

Pronouns

e.g. he/him/his

Jewish

Is JewishIs not JewishNon-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

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

Zip

Adult 2

Do you need to add a second adult?

Last Name

First Name

Nickname

if applicable

Pronouns

e.g. he/him/his

Jewish

Is JewishIs not JewishNon-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

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?

Person 1

Last Name

First Name

Nicknames

if applicable

Pronouns

e.g. he/him/his

Jewish

Is JewishIs not JewishNon-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 JewishIs not JewishNon-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?

NoYes

Life Cycle Events

Is there a Bar / Bat / B'nai Mitzvah planned within the next two years?

Please Select OneYesNo

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?

Wed, February 8 2023 17 Shevat 5783

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