Join

Your Name*

Hebrew Name

Date of Birth*

Spouse's Name

Spouse's Hebrew Name

Spouse's Date of Birth

Anniversary Date

Children

Name	Hebrew Name	Date of Birth

Are you a:

Kohen
Levi
Yisrael

Is your spouse a:

Kohen
Levi
Yisrael

Home Address*

Street Address Address Line 2 City State ZIP Code

Home Phone*

Email*

Work Email

Business Address

Street Address Address Line 2 City State ZIP Code

Business Phone

Yahrzeits

If you observe any yahrzeits, please list them below.

Name	Date of Death	Relationship

Please check committees or activities of interest to you:

Leading Services
Minyan
Teaching Hebrew School
Adult Education
Sisterhood
Board of Education
Ritual Committee
Hadassah
Other

If other, please describe below:

While we welcome all spiritual paths, in order to be a member you must be of the Jewish faith. Do you believe in any other religion? Please describe your path to Judaism.

Signature*

I hereby apply for membership in Congregation Beth Israel of Lebanon, Pennsylvania. In the event of my acceptance as a member, I agree to abide by the constitution, by-laws and other rules and regulations of the congregation now in force or hereafter to be adopted, and pay the amount of dues, as may be established.

CAPTCHA

Membership Application