Gender Please choose one. Male Female Nonbinary Other
* State--Select State-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Regular access to email? Please select one. Yes, please send as much communication via email as possible. No, I/we do not have access to email and require physical mailings when possible. In order to minimize use of paper products, most of our member communications are via email. Please indicate whether you have regular access to email.
In which religious tradition were you raised? Please choose one. Reform Conservative Orthodox Reconstructionist Renewal Non-practicing Non-Jewish
Is this the first time you've become a member of a Jewish congregation? Please choose one. Yes No
Of what other Jewish congregation(s) have you been a member? Please indicate name(s) and location(s) of previous/other congregation(s).
As a member of another congregation, in what programs, committees, or activities have you been involved?
* Which of these best describes you?Please Select One Single Divorced Widow/Widower Partnered Married
Is your spouse also Jewish? Please choose one. Yes No
Spouse's Gender Please choose one. Male Female Nonbinary Other
Is your partner also Jewish? Please choose one. Yes No
* Partner's GenderPlease choose one. Male Female Nonbinary Other
* Do you have children under the age of 18?Please choose one. Yes No
Child 1 Gender Please choose one. Male Female Nonbinary Other
Child 1 Grade in Secular School Please choose one. Too young for secular school Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12
Does this child have previous religious school experience? Please choose one. Yes No
Is this child a bar/bat mitzvah? Please choose one. Yes No
Has this child completed confirmation? Please choose one. Yes No
Will this child be interested in Eitzim Hub, our educational community for children of all ages? Please choose one. Yes No
Do you have more children under 18? Please choose one. Yes No
Child 2 Gender Please choose one. Male Female Nonbinary Other
Child 2 Grade in Secular School Please choose one. Too young for secular school Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12
Does this child have previous religious school experience? Please choose one. Yes No
Is this child a bar/bat mitzvah? Please choose one. Yes No
Has this child completed confirmation? Please choose one. Yes No
Will this child be interested in Eitzim Hub, our educational community for children of all ages? Please choose one. Yes No
Do you have more children under 18? Please choose one. Yes No
Child 3 Gender Please choose one. Male Female Nonbinary Other
Child 3 Grade in Secular School Please choose one. Too young for secular school Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12
Does this child have previous religious school experience? Please choose one. Yes No
Is this child a bar/bat mitzvah? Please choose one. Yes No
Has this child completed confirmation? Please choose one. Yes No
Will this child be interested in Eitzim Hub, our educational community for children of all ages? Please choose one. Yes No
Do you have more children under 18? Please choose one. Yes No
Child 4 Gender Please choose one. Male Female Nonbinary Other
Child 4 Grade in Secular School Please choose one. Too young for secular school Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12
Does this child have previous religious school experience? Please choose one. Yes No
Is this child a bar/bat mitzvah? Please choose one. Yes No
Has this child completed confirmation? Please choose one. Yes No
Will this child be interested in Eitzim Hub, our educational community for children of all ages? Please choose one. Yes No
Do you have more children under 18? Please choose one. Yes No
Mazal tov!
Do you have adult children? (Please note that adult children are not included in family membership.) Please choose one. Yes No
Please list the names and dates of birth of your adult children.
Do you have grandchildren? Please choose one. Yes. No.
Please list the names and dates of birth of your grandchild(ren).
We look forward to getting to know you! To get us started, please let us know a little bit about you. Where were you born? Where have you lived? What do you do for a living? Are you retired? Share as much or as little as you like.
What do you hope to experience as a member of Congregation Albert?
* Please check this box after reading our Code of Ethics.* Please check this box after reading the following:Membership at Congregation Albert requires an annual pledge. Each member pledges in order to sustain temple operations (e.g., programming, music, education, youth, salaries, repair and maintenance, insurance, and utilities). Congregation Albert is committed to a Fair Share Pledge Policy, expecting each member to contribute based on financial ability. This policy recognizes we have a collective responsibility to pledge according to our individual means. The suggested pledge amount is based on 2% of your adjusted gross income, which is your annual income before tax deductions. No current or prospective member is denied membership because of financial hardship.
