DONATE
WATCH SERVICES ONLINE
Membership Application4144 Chase Avenue @ Miami Beach, FL 33140305.538.7231 @ www.tbsmb.orgW E L C O M E(Please enter name(s) as you wish it to be listed on Temple roster, i.e. Jane and Jon Cohen.)
Name *
Home Address *
City *
State *
Zip Code *
Primary Phone *
Type of Membership Single Family
Is billing address the same: Yes No *
If no, write billing address
Address (City, State & Zip)
Phone
Full Name (include maiden name) *
Hebrew Name
Nickname
Date of Birth ...
Gender
Occupation/Profession
Specialization or Expertise
E-Mail Address *
Cellular Phone (if none enter primary #) *
Home Fax Number
Business Name
Business Address
Business City, State, Zip
Business Phone & ext. no.
Business Fax Number
Vacation Address
Birthplace
Religious Tradition in which you were raised. Reform Reconstructionist Conservative Non-Practicing Orthodox Other
Are you related to a TBS member? Yes No
If so, list member name.
How are you related?
Current or previous Temple affiliation.
Reason for joining Temple Beth Sholom
Referred by
Full Name (include maiden name)
E-Mail Address
Cellular Phone (if none enter primary #)
If applicable, please fill in the following information as it applies to each of your children.
First Name
Middle Name
Surname if different
Birthdate ...
Gender Male Female
Name of school
Current grade
Are your child(ren) attending Temple Beth Sholom Foundation School SLJ Religious School
Child's email address, if applicable
Bar/Bat Mitzvah Date ...
Confirmation Date ...
If College Student, school name
Expected date of graduation
If adult, occupation
Address if not living with you (specify address)
Is this a college address? Yes No
If applicable, please list present affiliations in Miami civic & cultural clubs, Jewish & community organizations:
Are you and/or your spouse a survivor of the Holocaust or children of survivors? Yes No
Can you and/or your spouse read or speak Hebrew? Yes No
Would you like to have a personal meeting with one of our rabbis? Yes No
Name
Relationship
Please list names and dates of those for whom you wish Yahrzeit (anniversary of death) notices sent.
Please make sure to include the English date of death AND year.
Name of deceased
English date of death ...
Before or After Sundown Before After
Relationship to Which Member
Would you like to observe Hebrew date or English date? Hebrew English
Please enter the letters & numbers below.