Online Membership Form - Temple Emanuel

Date

We define a household as the adults and children in an immediate family who live together at the same address. Use separate lines to tell us about each member of your household.

First and last names

Preferred pronouns

Complete Hebrew name (if known)

Date of birth

Your home address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone numbers - Use a separate line for each adult member of your household. Please star the preferred number(s) for calls.

First name

Cell phone

Home phone

Email addresses - We send statements and newsletters by email when at all possible. Use a separate line for each adult member of your household, and star the email address(es) preferred for statements and newsletters.

First name

Email address

Occupations - Use a separate line for each adult member of your household. If retired, give the previous occupation.

First name

Current occupation

Retired / previous occupation

Emergency contacts - Use a separate line for each adult member of your household.

First name

Name of cmergency contact

Phone number

We want to be inclusive of all our members. Please share with us any conditions or limitations for which you would like us to make accommodations:

Religious upbringing - use a separate line for each adult member of your household. If you choose "Other," please explain in the box that follows.

First name

Jewish: Reform, Conservative, Orthodox, Other

Non-Jewish: Denomination/sect, Other

Please feel free to elaborate on any of your responses so far:

Parents' names - use a separate line for each adult member of your household.

First name

Father's English name

Father's Hebrew name

Mother's English name

Father's English name

Yahrzeit record - Our congregation reads the names of deceased loved ones during the Hebrew week of the anniversary of their passing. Please provide the English date of death, and we will take it from there.

Name of loved one

Relationship (to whom)

Date of death

Temple Emanu-El has a burial area in White Haven Cemetery in Pittsford, NY. If any of the members of your household already have a burial plot, please share where they are located.

Please contact me/us regarding burial plots.

yes

Please contact me/us regarding memorial plaques.

yes

We value our sense of community and invite you to participate in our teams and activities. For each choice, write in the name(s) of the adult member(s) of your household who would like more information.

Adult Education

Caring Community

Cemetery

Finance and Budget

Food / Cooking

Office Work

Marketing / Publicity

Music

Membership

Social Activities

Tikkun Olam / Social Action

Ritual

Jewish Studies

Hebrew Studies

Book Groups

Do you have any skills, talents, and/or interest that you would like to share with us? For each choice, write in the name(s) of the adult member(s) of your household to whom it applies.

Accounting

Art / Design

Crafts

Sewing

Music / Theater

Nature / Outdoors

Photography

Legal

Writing / Editing

Lead a service

Read Hebrew

Read / Chant Torah

When are you available to attend activities, classes, or programs? For each choice, write in the name(s) of the adult member(s) of your household to whom it applies.

Weekday morning

Weekday afternoon

Weekday evening

Saturday morning

Saturday afternoon

Saturday evening

Sunday morning

Sunday afternoon

Sunday evening

Which programs/classes/activities might interest you? For each choice, write in the name(s) of the adult member(s) of your household to whom it applies.

Adult Bar/Bat/Bax Mitzvah class

Cooking class

Social activities group (movies, dinners, etc)

Giving rides to services and events

Planned charitable giving from your estate

Tax advantages to charitable giving from IRA mandatory withdrawals

Other suggestions for programs/classes/activities:

Members Directory - May we include your name(s) and contact information in our Members Directory, available to Team Chairs and other Temple Emanu-El members who may need it for their Temple Emanu-El roles? Please answer for each adult member of your household.

First name

Yes

Photo Release - Please answer for each adult member of your household: I grant Temple Emanu-El permission to use video and photos of my participation in congregational events. I further agree that any or all of the material photographed may be used, in any form, as part of any future publications to promote Temple Emanu-El.

First name

Yes

Introducing you - We'd like to introduce you to our other Temple Emanu-El members via our newsletter. If you would prefer to write your own introductory bio, please do so below. Otherwise, a member of our congregation will be happy to contact you for an interview for the newsletter.