2024-25 Beth El New Membership Application & Dues - Form

4900 BRIARHAVEN ROAD, FORT WORTH, TEXAS 76109
(817) 332- 7141 | FAX (817) 332-7157

2024-25 MEMBERSHIP APPLICATION & DUES FORM
BUILDING THE JEWlSH FUTURE

IS THERE MORE THAN ONE ADULT MEMBER ON THE ACCOUNT?YesNo

CONTACT INFORMATION - PRIMARY MEMBER

* Primary Member - First Name

* Primary Member - Last Name

* Primary Member - Birthday

Primary Member - Hebrew Name

* Primary Member - Email

* Primary Member - Mobile Phone

Primary Member - Place of Business

Primary Member - Business Phone

Primary Member - Religious Experience

INTERESTS - PRIMARY MEMBER

Interests & Skills

Committees & Special Interests

CONTACT INFORMATION - SECONDARY MEMBER

* Secondary Member - First Name

* Secondary Member - Last Name

* Secondary Member - Birthday

Secondary Member - Hebrew Name

* Secondary Member - Email

* Secondary Member - Mobile Phone

Secondary Member - Place of Business

Secondary Member - Business Phone

Secondary Member - Religious Experience

INTERESTS - SECONDARY MEMBER

Interests & Skills

Committees & Special Interests

ADDITIONAL ACCOUNT INFORMATION

* Marital Status

* Anniversary Date (if applicable?)

HOME RESIDENCE INFORMATION

* Address

* City

* State

* Zip

Home Phone (if applicable)

CHILDREN INFORMATION

* Do you have Children to add to your member account?

Please Select OneYesNo

Please select the "+" to add your Children

* Child's Full Name

Child's Hebrew Name

* Child's Date of Birth

Please select the "+" to add more Children

YAHRZEIT INFORMATION

* Do you have Yahrzeits to add to your member account?

Please Select OneYesNo

Please select the "+" to add your Yahrzeits

* Full Name

* Mourner's Name

* Relationship

* English Date of Death

* Permanant Memorial

Location of Memorial

Please select the "+" to add more Yahrzeits

MEMBERSHIP DUES LEVEL

FINANCIAL ASSISTANCE

No one will be denied Membership at Congregation Beth El due to financial circumstances. If membership costs are a genuine hardship for you, please select the checkbox below and Renee Woods, the Executive Director, will be in touch with you to make other financial arrangements.

I(we) will require Financial Assistance for the 2024-25 Membership year