Membership Application

Please select your membership category below. Please click on submit when complete. Once approved you will be contacted by a Shul representative.

FAMILY MEMBERSHIP

Annual Dues are $1,000 plus $250 EmergencySecurity Assesment Fee .Additional amounts are: Welfare Fund (annual dues + one time $10 initiation fee) $20, OU Dues $18, Eruv Dues $10, Vaad HaKashrus Dues $40

SINGLE MEMBERSHIP

Annual Dues are $500 plus $250 EmergencySecurity Assesment Fee . Additional amounts are: Welfare Fund (annual dues + one time $10 initiation fee) $20, OU Dues $18, Eruv Dues $10, Vaad HaKashrus Dues $40

WELFARE POLICY: A member who is 45 years old or younger at enrollment is entitled to Welfare Benefits: a plot in the Congregation's cemetery grounds for himself, his wife and any unmarried children under 18. Any member enrolling over age 45 can qualify for Welfare Benefits on payment of additional retroactive fees, as established by the Welfare Committee.

* Last Name

* Primary First Name

Title

Gender

Tribe

Occupation

Business Phone No.

Primary's Cell Phone

* Primary's Email Address

Primary's Date of Birth

Primary's Hebrew Name

Primary's Father's Hebrew Name

Primary's Mother's Hebrew Name

Which Minyan will you be joining?

I am interested in the having my children participate in the Youth Department activities

Secondary Last Name

Secondary First Name

Title

Gender

Occupation

Business Phone No.

Secondary's Cell Phone

Secondary's Email Address

Secondary's Date of Birth

Secondary's Hebrew Name

Secondary's Father's Hebrew Name

Secondary's Mother's Hebrew Name

* Address

Address 2

* City

* State

* Zip

Home Phone

CHILDREN

Child 1

Name

Hebrew Name

Date of Birth

Child 2

Name

Hebrew Name

Date of Birth

Child 3

Name

Hebrew Name

Date of Birth

Child 4

Name

Hebrew Name

Date of Birth

Child 5

Name

Hebrew Name

Date of Birth

Child 6

Name

Hebrew Name

Date of Birth

YAHRZEITS

Full English Name

Hebrew Name

Father's Hebrew Name

Hebrew Date of Death

Relationship to You

Other Relationship

Mourner's Name

Full English Name

Hebrew Name

Father's Hebrew Name

Hebrew Date of Death

Relationship to You

Other Relationship

Mourner's Name

Full English Name

Hebrew Name

Father's Hebrew Name

Hebrew Date of Death

Relationship to You

Other Relationship

Mourners Name

Full English Name

Hebrew Name

Father's Hebrew Name

Hebrew Date of Death

Relationship to You

Other Relationship

Mourners Name

No one will be turned away from membership for financial reasons. If you cannot pay full membership please contact the Shul office at office@whiteshul.com. We will be happy to work with you in a completely private manner.

Please read the following:

I join my fellow congregants in seeking a future for our Shul that is consistent with its legacy of meaningful tefillah, dissemination of Torah, and dedicated service to the community and beyond. I share the vision of nurturing an atmosphere where all who participate in the Shul's many activities will feel a sense of belonging, elevation, and excitement as they arrive to daven, learn, and perform acts of chesed.

Toward the goal of generating and maintaining such an environment, I express my commitment to help bring the tefillah experience offered by our Shul to a level that befits its standing as a Torah institution of the highest caliber. Accordingly, I pledge, bli neder, to refrain from conversation throughout tefillah, and to foster an atmosphere conducive to meaningful prayer, reflection, and connection with HaKadosh Baruch Hu.

I have read and agree to the above

Thu, March 6 2025
6 Adar 5785

Thu, March 6 2025 6 Adar 5785

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