CommSyn Membership Application_Booklet

We Look forward to connecting with you Membership ApplicationIs there anything else you would like us to know? Welcome to Our Synagogue Family! Family Information Adult 1  Male  Female Date of  Jewish by birth  Jewish by choice  Not Jewish Birth Nickname Title First Last (if aplicable) Street Address Name Name City State zip Home Work Cell Phone Phone Phone Email AddressYahrzeits (continued) Date of Death Marital Status  Single  Married Anniversary Date (if applicable) _________  Partnered  Separated  Divorced  WidowedName of (Must include year)Deceased Business OccupationRelationship  Before Sundown  After Sundown Name(To Which Member)Name of Date of Death Business State zipDeceased (Must include year) AddressRelationship(To Which Member)  Before Sundown  After Sundown Jewish Talents:  Teach Hebrew  Sing in Choir  Lead Services  Chant Torah  Chant HaftarahName ofDeceased Date of Death Name and City of Previous Congregation (if applicable)Relationship (Must include year)(To Which Member)  Reform  Conservative  Reconstructionist  Orthodox  Other  Held lay leadership position?Name of  Before Sundown  After SundownDeceased Adult 2 (if applicable)Relationship Date of Death(To Which Member) (Must include year)  Male  Female Date of  Jewish by birth  Jewish by choice  Not JewishName of BirthDeceased  Before Sundown  After Sundown NicknameRelationship Title First Last (if aplicable)(To Which Member) Date of Death Street Address Name Name (Must include year)  Before Sundown  After Sundown City State zipAdult 1 Signature_____________________________________________________________________________ Date ���������������������� Home Work CellAdult 2 (if applicable) Signature_________________________________________________________________ Date ���������������������� Phone Phone Phone Email Address Marital Status  Single  Married Anniversary Date (if applicable) _________  Partnered  Separated  Divorced  Widowed Business Occupation Name Business State zip Address Jewish Talents:  Teach Hebrew  Sing in Choir  Lead Services  Chant Torah  Chant Haftarah Name and City of Previous Congregation (if applicable) 160 Middle Neck Road • Port Washington, NY 11050  Reform  Conservative  Reconstructionist  Orthodox  Other  Held lay leadership position? 516 883 3144 • www.commsyn.org

Family Information (continued) Talents / Skills / Interests Adult 2 (if applicable)Child(ren)'s Information (if applicable) Adult 1Child 1  Male  Female Date of Hebrew Name Grade as of this What are your passions? What are your interests? What are your passions? What are your interests? Birth (If Known) Coming September Last :: Adult Learning :: Adult LearningFirst Name :: Art (viewing and/or creating) :: Art (viewing and/or creating)Name :: Board Games :: Board Games :: Bowling :: BowlingFor Office Use Only: CHILD 1 TCS RS  Now attending  Has attended  Will attend :: Bridge :: BridgeTCS ECC  Now attending  Has attended  Will attend :: Brotherhood :: Brotherhood Hebrew Name Grade as of this :: Calligraphy :: CalligraphyChild 2  Male  Female Date of (If Known) Coming September :: Camping :: Camping Birth Last :: Carpentry :: Carpentry Name :: Chaverim (active seniors group) :: Chaverim (active seniors group)First :: College Parents :: College ParentsName  Will attend TCS RS  Now attending  Has attended  Will attend :: Computer Graphics :: Computer Graphics :: Cooking/Baking :: Cooking/BakingFor Office Use Only: CHILD 2 Hebrew Name Grade as of this :: Crafts :: CraftsTCS ECC  Now attending  Has attended (If Known) Coming September :: Cycling :: Cycling Last :: Dancing/Israeli Dancing :: Dancing/Israeli DancingChild 3  Male  Female Date of Name :: Delivering food to those in need :: Delivering food to those in need Birth :: Driving those in need :: Driving those in need :: Early Childhood Parenting :: Early Childhood ParentingFirst  Will attend TCS RS  Now attending  Has attended  Will attend :: Event/Party Planning :: Event/Party PlanningName :: Exercise :: Exercise Hebrew Name Grade as of this :: Films/Movies :: Films/MoviesFor Office Use Only: CHILD 3 (If Known) Coming September :: Fundraising :: FundraisingTCS ECC  Now attending  Has attended Last :: Gardening :: Gardening Name :: Golf :: GolfChild 4  Male  Female Date of :: Guitar :: Guitar Birth :: Hiking :: Hiking :: Knitting/Crocheting :: Knitting/CrochetingFirst  Will attend TCS RS  Now attending  Has attended  Will attend :: Library/Book Clubs :: Library/Book ClubsName :: Mah Jongg :: Mah Jongg :: Marketing & Communications :: Marketing & CommunicationsFor Office Use Only: CHILD 4 :: Mitzvah Corps :: Mitzvah CorpsTCS ECC  Now attending  Has attended :: Music/Singing/Band :: Music/Singing/Band :: Photography :: PhotographyPlease list any relatives or Close Friends in our congregation and their relationship to you :: Religious Living :: Religious Living :: Religious School Parents :: Religious School ParentsYahrzeits :: Retail/Judaica Shop :: Retail/Judaica Shop :: Sewing/Needlework/Quilting :: Sewing/Needlework/QuiltingEach household may acknowledge the anniversaries of relatives’ deaths, using either the Hebrew or English calendar. You will receive a :: Sisterhood :: Sisterhoodreminder of when to light a memorial candle for your loved one, and when his/her name will be read during the corresponding Shabbat :: Skiing :: Skiingservice. Jewish and non-Jewish relatives may be honored. Please continue on the back page if necessary. :: Social Action (Tikkun Olam) :: Social Action (Tikkun Olam) :: Social Media :: Social MediaWhich calendar do you choose to observe?  Hebrew date  English Date :: Sports – Playing/Coaching :: Sports – Playing/Coaching :: Theatre :: TheatreName of Date of Death :: Travel :: TravelDeceased (Must include year) :: Tutoring Children :: Tutoring ChildrenRelationship :: Videography :: Videography(To Which Member)  Before Sundown  After Sundown :: Visiting with the Elderly :: Visiting with the ElderlyName of :: Volunteering – as needed :: Volunteering – as neededDeceased Date of Death :: Welcoming New Members :: Welcoming New MembersRelationship (Must include year) :: Writing/Editing :: Writing/Editing(To Which Member) :: Youth Groups :: Youth GroupsName of  Before Sundown  After Sundown :: Other _________________________________________________ :: Other _________________________________________________DeceasedRelationship Date of Death(To Which Member) (Must include year)Name ofDeceased  Before Sundown  After SundownRelationship(To Which Member) Date of Death (Must include year)  Before Sundown  After Sundown