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:
Our current sustaining financial commitment is $3200 annually, meaning that if every member household contributed this amount, our income would cover all of our operating needs. However, no current or prospective member is denied membership because of financial hardship. Thank you for your support!
If able, please consider joining our Chai Circle donors.
CHAI CIRCLE Pillar Circle :$3,540 and over ($295+ per month)Guardian Circle : $5,720 and over ($476+ per month) Pinnacle Circle : $10,720 and over ($893+ per month) Those blessed with the ability to contribute in these categories provide the stability upon which our future is built. These donors will be recognized in the coming year.
* Your Annual Membership Financial Commitment may be made in one lump payment, or divided during the course of the fiscal year. Please indicate how you would like to schedule your payments.Please Select One Monthly One annual payment Two semi-annual payments (every six months) Quarterly (July, October, January, April)
Annual Payment: In which month of each year will your payment be made? July August September October November December January February March April May June
* Please indicate your method of payment for your Financial Commitment..Please Select One Automatic bank withdrawal Credit card Check Other
$2000 , in one lump sum or over five years, is suggested. New members who can show documentation of completion of a Building Fund pledge to another Union for Reform Judaism (URJ) synagogue in the past 10 years are exempt from this requirement.
Please indicate the amount of your Building Fund pledge below, and how you plan to fulfill your pledge. No credit card or bank account information is required at this time, and no payment will be collected at this time.
Your contribution to the Building Fund may be broken down over time. For example:
Monthly, over two years = $83.33/month = $2000
Monthly, over three years = $55.56/month = $2000
Monthly, over five years = $33.33/month = $2000
If you can show documentation of completion of a Building Fund pledge to another Union for Reform Judaism (URJ) synagogue in the past 10 years, please enter $1.00 as your Building Fund pledge (you will not be billed for this pledge), and send documentation of your completed Building Fund pledge to ed@congregationalbert.org.
Please indicate the time period over which your Building Fund pledge will be paid. One year Two years Three years Four years Five years
How frequently will you contribute towards your Building Fund pledge? One time payment (full pledge amout) Annually Semi-annually (July and January) Quarterly (July, October, January, April) Monthly
