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Membership Application-Full Version
Please verify reCaptcha before submitting the form.
Whether you have been connected to CBI for years or are new, we are delighted to have you join us as a member. To join Congregation B'nai Israel please complete this application.
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.
BENEFITS OF MEMBERSHIP INCLUDE:
Life Cycle Events
You will be part of a caring community when you experience a life cycle events such as a Brit-milah and Brit bat (baby-naming) ceremony, Bar/Bat Mitzvah, marriage ceremony, shiva and funeral services. CBI membership provides you with cemetery privileges in our Jewish and Interfaith cemeteries.
Worship and Holiday Services
Your membership helps support the High Holiday services, weekly Shabbat Services, and special Chanukah, Purim, Pesach, Shavuot and other holiday services and celebrations during the year. All of these services are free with your membership, including free ticket(s) to High Holiday services.
Reciprocity
Members are eligible for reciprocity with participating synagogues for High Holiday tickets.
Adult Education
Membership pays for adult education classes, Sunday cafés with guest presenters, lecture series, and Shabbat luncheon programs. Members can participate in other adult experiences such as informal spirituality groups, havurahsmall community gatherings, dance programs, and presentations during senior luncheons.
Religious School
Members may enroll their children in (ALMA) religious school and membership helps support the education of our youth in providing subsidies to the school.
Voice in Shaping the Congregation
Members may serve on the Board, vote in elections and referenda, and serve on committees. A full list of Committees and opportunities for involvement are listed on the application form.
Ownership and Use of the Building
As a member you become part owner of the building that is a spiritual home, an event center, a kosher kitchen, a sanctuary (safe place for you and others), and a place to schmooze. Members have first priority for the use of meeting space, and special rates for rental of the social hall and kitchen.
Availability of Clergy
Members get first priority for a call on our Rabbi for pastoral counseling, hospital visitations, and similar needs
For more information about Membership types and fees, please
click here.
Please select one about your interest in membership.
Please Select One
I would like to discuss membership with a CBI Staff person.
I would like to be join as a member now.
*
Number of Adult Joining as Members
Please Select One
1 Adult
2 Adults
*
Primary Applicant First Name
*
Primary Applicant Last Name
Preferred Name or Nickname
Date of Birth
Pronouns
Hebrew Name
Ben/Bat
*
Address Line 1
Address Line 2
*
City
*
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
*
Zip Code
Home Phone
Mobile Phone
Work Phone
Email
Occupation
Company/Work Name
Marital Status
Single
Married
Engaged
Divorced
Widowed
Separated
N/A
Partnered
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.
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
Address Line 1
Address Line 2
City
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
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.
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.
Is your family an interfaith family?
no
yes
How did you hear about Congregation B'nai Israel?
Referred by someone
Newspaper/Ads
Website/Facebook
Other social media
How long have you been in this area?
If applicable, where did you move from?
How many children do you have?
0
1
2
3
4
More than 4 children
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?
yes
no
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)?
yes
no
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?
yes
no
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?
yes
no
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?
yes
no
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 One
yes
no
Yahrzeit 1 First Name
Yahrzeit 1 Last Name
Yahrzeit 1 Relationship to Applicant
Yahrzeit 1 Date of Passing
Time of Passing
Before sundown
After sundown
Yahrzeit 2 First Name
Yahrzeit 2 Last Name
Yahrzeit 2 Relationship to Applicant
Yahrzeit 2 Date of Passing
Time of Passing
Before sundown
After sundown
Yahrzeit 3 First Name
Yahrzeit 3 Last Name
Yahrzeit 3 Relationship to Applicant
Yahrzeit 3 Date of Passing
Time of Passing
Before sundown
After 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) are interested in receiving information about the following programs:
Abundance Farm
Adult Education
Family Programs (Celebratory gatherings during Jewish holiday seasons)
Gan Keshet Preschool
Shabbat Shabloom (monthly musical program for young children and their families)
Teen Life
Tikkun Olam (social justice)
Valley Jewish Senior Luncheons (monthly luncheons with guest speakers)
I am interested in volunteering for the following committees or activities:
Abundance Farm Advisory Board
Adult Education Committee
Bikkur Holim (visiting at hospitals)
Chesed (Caring community)
Cemetery Committee
Chevra Kadisha (Ritual Cleansing for Burial)
Education
Fundraising
Gan Keshet Preschool Committee
Israel Committee
Kiddush Committee (volunteer to prepare lunch on Shabbat)
Membership Committee
Ritual Committee
Tikkun Olam Committee
Valley Jewish Senior Luncheon Volunteer
My partner/spouse (if applicable) is interested in volunteering for the following committees or activities:
Abundance Farm Advisory Board
Adult Education Committee
Bikkur Holim (visiting at hospitals)
Chesed (Caring community)
Cemetery Committee
Chevra Kadisha (Ritual Cleansing for Burial)
Education
Fundraising
Gan Keshet Preschool Committee
Israel Committee
Kiddush Committee (volunteer to prepare lunch on Shabbat)
Membership Committee
Ritual Committee
Tikkun Olam Committee
Valley Jewish Senior Luncheon Volunteer
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 two options below:
I (We), would like to join at the membership level selected below
Two Adult Family Membership
One Adult Family Membership
Individual (One Adult) Membership
Limited (Dual/Sabbatical/Out of Town) 1 Adult
Limited (Dual/Sabbatical/Out of Town) 2 Adult
Sliding Scale
I (We) would like to pay the amount noted below:
Please submit your application after signing below and complete the payment section of this application.
Signature
Date
Fri, August 12 2022 15 Av 5782