Full Membership Application - Form - Congregation B'nai Israel

Whether you have been connected to CBI for years or are new, we are delighted to have you join us as a member.

As a member of Congregation B’nai Israel, you will be a part of a progressive, egalitarian, congregation associated with the conservative movement. As a member you will have a personal relationship with the rabbis, staff, and other members of the community.

IMPORTANT: PLEASE READ
For information about the benefits of membership, CBI's costs and revenue breakdown, and membership levels and fees, please click here.

If you will pay the standard dues amount for a 2 adult family, 1 adult family, individual, or dual membership, please complete this form and choose the payment option at the bottom. All standard dues memberships include a building fund payment of $170 per year for five years, so please add that amount below. You will have the choice to pay for dues in full or to divide it into several payments. You will be required to submit payment in order to finalize this form.

If you would like to have a conversation about membership before submitting an application, please fill out the Membership Interest Form.

We do not want dues to be a barrier to membership at CBI and are happy to help you determine the amount that makes sense for you. If you would like to discuss a sliding scale dues option, the membership process has different steps. Please start by filling out the Sliding Scale Membership form or the instead.

If you would like to talk with Amy Stein, CBI Engagement Coordinator, or if you have any questions before officially joining, please click on the link below.

www.cbinorthampton.org/form/membership

* Number of Adults Joining as Members

Please Select One1 Adult2 Adults

* Primary Applicant First Name

* Primary Applicant Last Name

Preferred Name or Nickname

* Date of Birth

Pronouns

Hebrew Name

Ben/Bat/M'Beit

Parent 1 Hebrew Name

Parent 2 Hebrew Name

* Address Line 1

Address Line 2

* City

* State

* Zip Code

Home Phone

Mobile Phone

Work Phone

Occupation

Company/Work Name

If married, anniversary date.

Previous Synagogue Affiliation (if any)

Concurrent Synagogue Affiliation (if any)

I understand my name and contact information will be added to the online member directory. I also understand I can update or remove that information by signing into my online account.

Partner or Spouse First Name (if applicable)

Partner or Spouse Last Name (if applicable)

Preferred Name or Nickname

Date of Birth

Pronouns

Hebrew Name

Ben/Bat/M'Beit

Parent 1 Hebrew Name

Parent 2 Hebrew Name

Address Line 1

Address Line 2

City

State

Zip Code

Partner or Spouse Mobile Phone

Partner or Spouse Email

Occupation

Company/Work Name

Spouse or Partner Work Phone

Previous Synagogue Affiliation (if any)

Concurrent Synagogue Affiliation (if any)

I understand my partner/spouse's name and contact information will be added to the online member directory. I also understand I can update or remove that information by signing into my online account.

Please feel free to share more about yourself and what has drawn you to CBI.

Child 1 First Name

Child 1 Last Name

Preferred Name/Nickname

Birthday

Hebrew Name

Pronouns

Child 1 Email

Is child living at the main address?

yesno

If no, indicate the address where the child lives.

Name of School

Current Grade

Are you interested in enrolling your child in ALMA (religious school)?

yesno

Child 2 First Name

Child 2 Last Name

Preferred Name/Nickname-Child 2

Birthday-Child 2

Hebrew Name-Child 2

Pronouns-Child 2

Child 2 Email (if applicable)

Is child living at the main address?

yesno

If no, indicate the address where the child lives.

Child 3 First Name

Child 3 Last Name

Preferred Name/Nickname-Child 3

Birthday-Child 3

Hebrew Name-Child 3

Pronouns-Child 3

Child 3 Email (if applicable)

Is child living at the main address?

yesno

If no, indicate the address where the child lives.

Child 4 First Name

Child 4 Last Name

Preferred Name/Nickname-Child 4

Birthday-Child 4

Hebrew Name-Child 4

Pronouns-Child 4

Child 4 Email (if applicable)

Is child living at the main address?

yesno

If no, indicate the address where the child lives.

If you have additional children, please list their information here.

Yahrzeit Information

It is custom of the congregation to read the names of loved ones who are no longer with us on the anniversary of their passing. You will be notified via mail from the CBI Office of the Hebrew date of your loved one’s death unless you specify the English/Gregorian date.

Do you wish to submit yahrzeit names and receive notices of the anniversary of their passing?

Please Select Oneyesno

Yahrzeit 1 First Name

Yahrzeit 1 Last Name

Yahrzeit 1 Relationship to Applicant

Yahrzeit 1 Date of Passing

Time of Passing

Before sundownAfter sundown

Yahrzeit 2 First Name

Yahrzeit 2 Last Name

Yahrzeit 2 Relationship to Applicant

Yahrzeit 2 Date of Passing

Time of Passing

Before sundownAfter sundown

Yahrzeit 3 First Name

Yahrzeit 3 Last Name

Yahrzeit 3 Relationship to Applicant

Yahrzeit 3 Date of Passing

Time of Passing

Before sundownAfter sundown

If you wish to submit additional yahrzeit names and dates, please type in the details here. Please include the secular (English) date of death.

I (we) am (are) interested in receiving information about the following programs:

Abundance FarmAdult EducationFamily Programs (Celebratory gatherings during Jewish holiday seasons)Gan Keshet PreschoolShabbat Shabloom (Shabbat musical program for families with children ages 5 and under)ALMA (religious school)Teen ProgramsTikkun Olam (social justice)

I (we) am (are) interested in volunteering at CBI on an occasional basis.

I would like to prepare kiddush lunch with a group of volunteersI would like to be a greeter for Shabbat servicesI am available to help set up and clean up for events and programsI would like to make dinners for community members who are sick or mourningI would like to volunteer to visit the sick in the hospitalI can provide rides for community membersI would like to help with office tasks

“Havurah: An Experiment in Jewish Gathering” is an initiative hosted by Congregation B’nai Israel that supports the development of homegrown, peer-led, Jewish gatherings. The goal of this initiative is to provide a platform for people to fill in gaps they experience in current Jewish programming and offerings by providing the structure and support for gathering and forming mini-communities that foster deep, caring, supportive relationships.

Viist the CBI website havurah page to learn more about the current groups: www.cbinorthampton.org/havurah.
Please indicate what groups you would like to learn more about.

Havurot

Healing Circle HavurahMah Jongg HavurahHilltowns Havdalah HavurahIsraeli Politics and Culture HavurahJewish Holidays HavurahI would like to discuss ideas for starting a new havurah

Notes or comments about volunteering, committees, or havurot interest and availability.

Please write any special talents, interests or ideas you wish to share with us to better serve the congregation:

Please select a membership level from the options below:

I (We), would like to join at the membership level selected below

Please check here to select Building Fee of $170. The prorated amount is $85.00. This fee is required. If you do not check this, you will be billed for it.

Please submit your application after signing below and complete the payment section of this application.

Type Signature

Date