Membership Application - Form - Congregation Or Atid

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Membership Application

Please verify reCaptcha before submitting the form.

* Are you married or partnered?

HOUSEHOLD INFORMATION

* Street Address

* City

* State

* Zip

Home Phone

Marital Status

Anniversary

MEMBER INFORMATION

Title (only if not Mr/Mrs/Ms)

Member 2 Title (only if not Mr/Mrs/Ms)

* First name

Nickname

* Member 2 First name

Member 2 nickname

Middle name

Member 2 middle name

* Last name

Member 2 last name

* Jewish heritage

* Member 2 Jewish heritage

For Hebrew name fields, use English or Hebrew characters

Hebrew name (not including parents)

Member 2 Hebrew name (not including parents)

Father Hebrew name

Member 2 father Hebrew name

Mother Hebrew name

Member 2 mother Hebrew name

Tribe

Member 2 Tribe

* Email

* Member 2 email

Cell

Member 2 Cell

Birthdate

Member 2 birthdate

Company/business name

Member 2 company/business name

Occupation/title

Member 2 occupation/title

CHILDREN INFORMATION

Please select how many children you (and/or your partner) have and then complete the requested information

First Name

Middle Name

Last Name

Nickname

Hebrew Name

Tribe

Parent 1 Hebrew Name

Parent 2 Hebrew Name

Birthday

Gender

Pronoun

Email (don't use parent email)

Cell (don't use parent cell)

YAHRZEIT INFORMATION

Please select how many yahrzeits your family observes and then complete the requested information for each yahrzeit

* Full English Name of Deceased

Full Hebrew Name of Deceased

Pronoun of Deceased

* Mourner in Family

* Deceased is mourner's (relationship)

* English Date of Death

Hebrew Date of Death (if known)

Cemetery (including city/state)

ADDITIONAL INFORMATION

Other or previous congregation affiliation (including location)

Interests

Adult bar/bat mitzvahAdult socialAdult educationYad chesed (caring committee)SisterhoodBrotherhoodFinanceCommunication/marketingFundraisingInterfaithParticipate in service/read Torah/ritualSocial actionYouth programsHoliday event planningMembershipTechnologyMusic, Arts & CultureCooking/KitchenBook Club

Photograph release: I allow Congregation Or Atid to use photographs of me and my family in any member communications or in publicity efforts outside of the synagogue.

Do you or your family members have any physical restrictions we should be aware of?

Please describe:

Are you related to other members at Congregation Or Atid or do you have friends who belong?

Please list:

* I/we hereby apply for membership in Congregation Or Atid and agree to support its religious, educational, and cultural activities.

I/we hereby apply for membership in Congregation Or Atid and agree to support its religious, educational, and cultural activities.

Wed, September 27 2023 12 Tishrei 5784

Congregation Or Atid, 97 Concord Road, PO Box 38, Wayland, MA 01778 508.358.9623 info@congregationoratid.org

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