______. Business Email Address ... Saw an advertisement about our programs. Came to services. ____High ... _____ Communi
Member of United Synagogue of Conservative Judaism
Congregation Habonim New Member Form 103 West End Ave
New York, NY 10023
212.787.5347
fax 212.595.3542
www.habonim.net
We are Habonim, “the builders,” a community that works together to build meaningful Jewish experiences for ourselves and our families. We extend an invitation to you to join our congregation for prayer, study and friendship, and hope that you will join us as we grow together as individuals, families and as a community. We look forward to a long and meaningful relationship with you.
Membership Information Adult #1 Title:
Mr.
Ms.
Mrs.
Adult #2 Dr.
Rabbi
Other
Title:
Mr.
Ms.
Mrs.
Dr.
Rabbi
Other
Name ________________________________________
Name ________________________________________
Hebrew Name ________________________________
Hebrew Name ________________________________
Parent’s Hebrew Name _______________________
Parent’s Hebrew Name ________________________
Parent’s Hebrew Name _______________________
Parent’s Hebrew Name ________________________
Date of Birth _____/______/__________
Date of Birth _____/______/__________
Home Address _______________________________
Home Address ________________________________
______________________________________________
_______________________________________________
Phone _______________________________________
Phone ________________________________________
Family/Personal Email ________________________
Family/Personal Email _________________________
Profession ___________________________________
Profession ____________________________________
Position/Title/Retired __________________________
Position/Title/Retired ___________________________
Company name______________________________
Company name_______________________________
Address ______________________________________
Address _______________________________________
______________________________________________
_______________________________________________
Business Phone ____________________ext._______
Business Phone ____________________ext._________
Business Email Address ________________________
Business Email Address _________________________
Please do not add this address to the Habonim e-newsletter list ❑
Mobile Phone ________________________________
Please do not add this address to the Habonim e-newsletter list ❑
Mobile Phone _________________________________
Wedding Date (if applicable) ____/____/____ For Office Use Only Dues Amount Dues with Application NS RS Date received
Children (under age 18) Name
Hebrew Name
Date of Birth
Bar/Bat Mitzvah date School/Occupation
Please let us know if any of your children have special needs (dietary, allergies, or learning) that we should be aware of.
Adult Children Name
Hebrew Name
Contact Information
Parents of Members Name
Hebrew Name
Contact information
Yahrzeits It is our custom to remind congregants of the yahrzeits of their loved ones. Name of Loved One (English)
(Hebrew) Name
Relationship Date of Death (to which member)
Please notify the synagogue office if you would like to add more yahrzeits
Time of Death (indicate day or night)
What brings you to Congregation Habonim? Nursery School
Friends belong (Names) ___________________
Religious School
Desire to be involved in a Jewish community
Family relationship with synagogue
Interested in learning and growing Jewishly
Neighborhood location
____Services
____Rabbi/Clergy
Other _____________________________________
____Lifecycle events How did you hear about us? Referred by a friend
Website
Saw an advertisement about our programs
Kiosk
Came to services
Other ____________________________________
____High holidays
Additional Information To celebrate our community, in our bulletin we list members’ birthdays (without year!), anniversaries, and contributions. If you wish to not have your name included, please check here to opt-out: □ Birthdays
□ Anniversaries
□ Contributions
Other affiliations Have you been involved with a synagogue in the past? We’d love to know more about your experience! _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ Have you been involved with other non-profit organizations? Any leadership positions (board member, committee chairperson, etc.)?
VOLUNTEER OPPORTUNITIES! “Do not separate yourself from your community.” - Pirkei Avot "The purpose of life is…to matter, to be productive, to be useful, to have it make some difference that you have lived at all." -- Leo Rosten Participating in various aspects of life at Congregation Habonim is one of the benefits of membership. While the involvement of our members strengthens our community in many ways, members of Habonim find that their participation deepens their connection to Judaism and to the community (and just feels good!). No matter what your background, there are opportunities for you to contribute. We look forward to getting to know you better through these activities! Make a difference and share your time and talents as a Volunteer (one-time, part time, any time!) for one or more opportunities listed below. You’re not making a commitment by checking anything below! We just want to get to know your interests as you join us. Contact Adina Rifkin (
[email protected] or 212 787 5347 extension 100) if you have questions.
We’re interested in the following areas: (please put initials of interested member where appropriate) Shabbat & Holiday Services (interest in either doing or learning!)
Administration
_____ Reading Torah
_____ Mailing, phone calls, stuffing envelopes
_____ Reading Haftarah
_____ Improving/Maintaining Website
_____ Giving D’var Torah
_____ Graphic Design (posters, promo materials)
_____ Leading Shabbat Beit Midrash
_____ Computer & Web Help
_____ Leading Services
_____ Communications (Newsletter/emails)
_____ Ushering (a great way to meet people!)
Community Outreach
_____ Managing Social Media
Areas of Interest
_____ Comforting Mourners (Menachem Avalim)
_____ Adult Education
_____ Visiting the Sick (Bikur Cholim)
_____ Israel Action & Affairs
_____ Call or Visit a Member (Bikur Chaverim)
_____ Nursery School
Host a Habonim Member _____ for a Shabbat or Holiday Meal
_____
_____ Queens Community
Religious School
_____ Sisterhood _____ Book Club _____ Men’s Club
Membership
_____ Social Action/Mitzvah Projects
_____ Public Relations
_____ Ritual Observance
_____ Marketing
_____ Youth Group
_____ Event Planning
_____ Family Programming
_____ Welcoming New Members _____ Fundraising
Other areas of expertise (e.g., writing, advertising, HR, finance, legal, videography/editing, working with children, etc.)_________________________________________________________________________________________
I/We hereby apply for membership in Congregation Habonim Signed
Signed ate
Individual Family Single Parent Family Young Professional ____Full-time Student Chaver
Membership type: please select one $1540 $2950 $1850 $180 individual/$360 family (under 30 years of age) $36 $575 (for those who live 50 or more miles from Congregation Habonim)
Special Promotions for new members: ____Getting married this year (or just married?) – Free membership for your first year! ____Signing up a child for K-2 grades of Habonim Religious School – 50% off your dues for your first year!
Please note: We do not deny any members due to financial hardship. If you cannot afford to pay these dues, please contact our Executive Director to have a confidential conversation.