Membership Registration Form - Form - Tiferet Bet Israel

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Membership Registration Form

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Membership Registration Form

We request this information for our confidential member files. Your assistance will allow us to serve you better. If you have any questions, please contact our office. Welcome to Tiferet Bet Israel!

HOUSEHOLD INFORMATION

* Home Address

* City

* State

* Zip Code

Home Phone

* HOUSEHOLD’S Previous Congregation Name

* HOUSEHOLD’S Previous Congregation City & State

* How did you hear about TBI?

FIRST ADULT HEAD OF HOUSEHOLD

* Adult 1 - Title

* Adult 1 - First Name

* Adult 1 - Middle Name

* Adult 1 - Last Name

* Adult 1 - Hebrew First Name

Please use TRANSLITERATION; please do not write in Hebrew letters.

* Adult 1 - Father's Hebrew Name

Please use TRANSLITERATION; please do not write in Hebrew letters.

* Adult 1 - Mother's Hebrew Name

Please use TRANSLITERATION; please do not write in Hebrew letters.

* Adult 1 - Tribe

* Adult 1 - Date of Birth

* Adult 1 - Gender

* Adult 1 - Relationship Status

Adult 1 - Anniversary Date (if applicable)

* Religious Background

* Other

* Adult 1 - Email Address

* Adult 1 - Mobile Phone

Adult 1 - Occupation

Adult 1 - Employer

Adult 1 - Work Phone

FIRST ADULT - INTEREST & SKILLS

Please provide information to help us connect you to the TBI community. This information will be shared with the appropriate committee or staff member.

Building/Grounds CommitteeCatering CommitteeChoirCommunications/Marketing CommitteeDevelopment (fundraising) committeeFinance CommitteeHebrew Language Skills

Hesed (caring) CommitteeHuman Resource CommitteeIsrael Advocacy CommitteeKashrut CommitteeLeadership Development/Governance CommitteeLifelong Learning CommitteeMembership Committee

Men’s ClubMinyan LeaderMusic CommitteeOutdoor Nature Classroom CommitteePlaying Instrumental MusicProgramming CommitteePTO (Religious School or Early Childhood)

Ritual CommitteeTechnology SkillsTorah/Haftorah readerVisual Art/Photography SkillsWomen’s LeagueYouth Commission

* Is there a second Adult applying for Membership?

SECOND ADULT HEAD OF HOUSEHOLD

* Adult 2 - Title

* Adult 2 - First Name

* Adult 2 - Middle Name

* Adult 2 - Last Name

* Adult 2 - Hebrew First Name

Please use TRANSLITERATION; please do not write in Hebrew letters.

* Adult 2 - Father's Hebrew Name

Please use TRANSLITERATION; please do not write in Hebrew letters.

* Adult 2 - Mother's Hebrew Name

Please use TRANSLITERATION; please do not write in Hebrew letters.

* Adult 2 - Tribe

* Adult 2 - Date of Birth

* Adult 2 - Gender

* Religious Background

* Other

* Adult 2 - Email Address

* Adult 2 - Mobile Phone

Adult 2 - Occupation

Adult 2- Employer

Adult 2 - Work Phone

SECOND ADULT - INTEREST & SKILLS

Please provide information to help us connect you to the TBI community. This information will be shared with the appropriate committee or staff member.

Building/Grounds CommitteeCatering CommitteeChoirCommunications/Marketing CommitteeDevelopment (fundraising) committeeFinance CommitteeHebrew Language Skills

Hesed (caring) CommitteeHuman Resource CommitteeIsrael Advocacy CommitteeKashrut CommitteeLeadership Development/Governance CommitteeLifelong Learning CommitteeMembership Committee

Men’s ClubMinyan LeaderMusic CommitteeOutdoor Nature Classroom CommitteePlaying Instrumental MusicProgramming CommitteePTO (Religious School or Early Childhood)

Ritual CommitteeTechnology SkillsTorah/Haftorah readerVisual Art/Photography SkillsWomen’s LeagueYouth Commission

CHILDREN RESIDING IN HOUSEHOLD

Full or part-time, through college age

Please click the + sign to add each child

* English Name: First, Middle, Last

* Hebrew Name

* Gender

* Date of Birth

* School

* High School Graduation Year

SIGNIFICANT ADULT NOT RESIDING IN HOUSEHOLD

(For example, divorced parent)

Please click the + sign to add each Adult

* English Name

Hebrew Name

* Relationship

* Synagogue Affiliation

Email Address

Mobile Phone

Home Phone

Work Phone

* Address

* City

* Zip Code

NOTE: If this individual is the separated or divorced parent of child(ren) enrolled in schools of Tiferet Bet Israel we will send duplicate mailings to him/her unless we are instructed otherwise by the member parent.

YAHRZEITS

Tiferet Bet Israel will send notice annually, approximately one month in advance of the Hebrew anniversary of death, as a reminder of yahraeit of your loved one. If the Hebrew date is not known, please indicate the time of day on the English date, to help establish the correct Hebrew date.

Please click the + sign to add each Yahrzeit

* English Name of Loved One: First, MI, Last

English Date of Death

* Before or after sundown?

* Hebrew Date of Death, if known

* Relationship, to which adult member (ex: Samuel’s father, son of Samuel and Esther, Esther’s Mother-in-law)

PERMISSION TO USE IMAGES OF HOUSEHOLD MEMBERS

Please indicate below your permission for TBI to record and use photographs and video of each household member for publicity purposes in our newsletter, on our website, in brochures, and for other materials.

Please click the + sign to add each family member

* Name of family member

* I give permission to TBI to use photos/videos of me or my child.

I give permission to TBI to use photos/videos of me or my child.

Wed, May 8 2024 30 Nisan 5784

TIFERET BET ISRAEL
1920 Skippack Pike
Blue Bell, PA 19422
p: 610-275-8797
e: exec@tbibluebell.org

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