Membership Application


TEMPLE BETH RISHON MEMBERSHIP APPLICATION
Date *
Date
Address *
Address
Home Phone *
Home Phone
ADULT #1
Adult 1 - Name *
Adult 1 - Name
Adult 1 -Birthdate
Adult 1 -Birthdate
Adult 1 -Phone (day) *
Adult 1 -Phone (day)
Adult 1 -Phone (evening) *
Adult 1 -Phone (evening)
Adult 1 - Cell *
Adult 1 - Cell
Adult #2
Adult 2 - Name
Adult 2 - Name
Adult 2 - Birthdate
Adult 2 - Birthdate
Adult 2 - Phone (day)
Adult 2 - Phone (day)
Adult 2 - Phone (evening)
Adult 2 - Phone (evening)
Adult 2 - Phone (cell)
Adult 2 - Phone (cell)
CHILDREN
Child 1 - Name
Child 1 - Name
Child 1 *
Child 1 - Date of Birth
Child 1 - Date of Birth
Child 2 - Name
Child 2 - Name
Child 2
Child 2 - Date of Birth
Child 2 - Date of Birth
Child 3
Child 3
Child 3 - Name
Child 3 - Date of Birth
Child 3 - Date of Birth
Child 4 - Name
Child 4 - Name
Child 4
Relatives who are Present Members of Temple of Beth Rishon
Relative 1 - Name
Relative 1 - Name
Relative 2 - Name
Relative 2 - Name
Please tell us how you heard about Temple Beth Rishon:
Please submit a $200.00 non-refundable application fee, which is required in order to process your membership. This fee will be applied towards your dues. The building Fund Donation of $2,500.00 is payable over 5 years. The first installment will be billed July 1st following the commencement of your membership. The Building Fund Donation will be reduced to $2,000.00 if paid within 60 days of joining the Temple.
WE UNDERSTAND THAT WE ARE OBLIGATED FOR THE CURRENT YEAR’S DUES AND A BUILDING FUND OBLIGATION. I/WE HAVE READ THE ABOVE AND AGREE TO ITS TERMS
* By checking this box and typing my name below, I am electronically signing this form.
* By checking this box and typing my name below, I am electronically signing this form.
Click SUBMIT and the form will be delivered to the Temple Office. Please send your check to: Temple Beth Rishon, 585 Russell Avenue, Wyckoff, NJ 07481