Membership Form | Congregation Dor Hadash

Adult 1

Name

JewishIs JewishIs not Jewish

Non-Jewish spouses and partners are always welcome to become members of Dor Hadash. However, for proper assignment of ritual tasks, Dor Hadash would like to know if someone is Jewish.

Date of Birth

Please use English transliterations for your Hebrew name and the Hebrew name of your parents.

Hebrew Name

Parent 1 / Mother's Hebrew Name, if known (otherwise, English name)Parent 2 / Father's Hebrew Name, if known (otherwise, English name)

Phone

Email AddressBar / Bat / B'nai Mitzvah DateTorah Portion

Accessibility Considerations and Accommodations

Home Address

StreetCityStateZip Code

Adult 2

Leave blank if not applicable

Name

JewishIs JewishIs not Jewish

Non-Jewish spouses and partners are always welcome to become members of Dor Hadash. However, for proper assignment of ritual tasks, Dor Hadash would like to know if someone is Jewish.

Date of Birth

Please use English transliterations for your Hebrew name and the Hebrew name of your parents.

Hebrew Name

Parent 1 / Mother's Hebrew Name, if known (otherwise, English name)Parent 2 / Father's Hebrew Name, if known (otherwise, English name)

Phone

Email AddressBar / Bat / B'nai Mitzvah DateTorah Portion

Accessibility Considerations and Accommodations

Others Living in the Household

Person 1

Leave blank if not applicable

Name

Non-Jewish spouses and partners are always welcome to become members of Dor Hadash. However, for proper assignment of ritual tasks, Dor Hadash needs to know if you are Jewish.

Is JewishIs not JewishDate of Birth

Please use English transliterations for your Hebrew name and the Hebrew name of your parents.

Hebrew NameSon / Daughter / Child of Bar / Bat / B'nai Mitzvah DateTorah Portion

Accessibility Considerations and Accommodations

Others Living in the Household

Person 2

Leave blank if not applicable

Name

Non-Jewish spouses and partners are always welcome to become members of Dor Hadash. However, for proper assignment of ritual tasks, Dor Hadash needs to know if you are Jewish.

Is JewishIs not JewishDate of Birth

Please use English transliterations for your Hebrew name and the Hebrew name of your parents.

Hebrew NameSon / Daughter / Child of Bar / Bat / B'nai Mitzvah DateTorah Portion

Accessibility Considerations and Accommodations

Others Living in the Household

Are there any additional people in your household other than those listed above?YesNo

Life Cycle Events

Is there a Bar / Bat / B'nai Mitzvah planned within the next two years?YesNo

Is there an upcoming wedding, special anniversary, baby-naming, or other life event expected?Yizkor

Please list names of the departed to be remembered at Yizkor Services on Yom Kippur.

Yahrzeits

Please include Yahrzeit information as follows: after each name, indicate date, month and year of death based on the English calendar. Please indicate if time of death was before or after sunset.

Where did you find out about Dor Hadash?

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Congregation Dor Hadash Membership Form

2021 - 2022

Adult 1

Home Address

Adult 2

Others Living in the Household

Person 1

Others Living in the Household

Person 2

Others Living in the Household

Life Cycle Events

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