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Sponsored by: Open Hearts. Open Minds. Strong Values.
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New Member Information
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New Member Information
Welcome to Congregation Beth Israel (CBI). We are delighted you have chosen to become part of this community. Please feel free to call upon the clergy, staff, and lay leaders whenever we can help enrich your experience as part of the CBI family.
Adult 1:
*
First Name
*
Last Name
Nickname
Hebrew Name
Occupation/Title
Employer
Personal Pronouns (she, he, they, ze, etc.)
(Learn more about personal pronouns.)
*
Date of Birth
*
Relationship Status
Please Select One
Single
Partnered
Married
Adult 2:
First Name
Last Name
Nickname
Hebrew Name
Occupation/Title
Employer
Personal Pronouns (she, he, they, ze, etc.)
(Learn more about personal pronouns.)
Date of Birth
Special Accommodations Needed (mobility concerns, physical limitation). If yes, please describe your needs:
Adult 1 (accommodations needed):
Adult 2 (accommodations needed):
Please list any relatives who are affiliated with CBI:
Mailing & Contact Information
*
Home Address
*
City
*
State
*
Zip
Home Phone
Adult 1
*
Cell Phone
Work Phone
*
Email
Adult 2
*
Cell Phone
Work Phone
Email
*
I/we give permission to share my/our contact information with other CBI members in the online membership directory.
Yes
No
Religious Background
Adult 1
Reform
Reform
Conservative
Conservative
Orthodox
Orthodox
Jewish - Unaffiliated
Jewish - Unaffiliated
Other
Adult 2
Reform
Reform
Conservative
Conservative
Orthodox
Orthodox
Jewish - Unaffiliated
Jewish - Unaffiliated
Other
Previous Synagogue Attended, if any:
Children
Child 1:
First Name
Last Name
Hebrew Name
Personal Pronouns (she, he, they, ze, etc.)
Date of Birth
Current Grade
Living at home?
Yes
No
Will this child be attending Religious School (grade K-12)?
Yes
No
Child 2:
First Name
Last Name
Hebrew Name
Personal Pronouns (she, he, they, ze, etc.)
Date of Birth
Current Grade
Living at home?
Yes
No
Will this child be attending Religious School (grade K-12)?
Yes
No
Child 3:
First Name
Last Name
Hebrew Name
Personal Pronouns (he, she, they, ze, etc.)
Date of Birth
Current Grade
Living at home?
Yes
No
Will this child be attending Religious School (grade K-12)?
Yes
No
If you have more than three children, please let us know so we can collect their information.
Emergency Contact
Emergency Contact - Name
Relationship
Phone number
Yahrzeits
The names of your deceased loved ones can be read in services the Shabbat before the Yahrzeit date (the anniversary of death).
1. Deceased - Full Name
Relationship
Hebrew Name
Date of Death
Observed by:
Adult 1
Adult 2
Observe:
Hebrew Date or
Secular Date
2. Deceased - Full Name
Relationship
Hebrew Name
Date of Death
Observed by:
Adult 1
Adult 2
Observe:
Hebrew Date
Secular Date
3. Deceased - Full Name
Relationship
Hebrew Name
Date of Death
Observed by:
Adult 1
Adult 2
Observe:
Hebrew Date
Secular Date
If you have more yahrzeits to observe, please let us know.
Member Interests
CBI is an active community and there are many ways to get involved!
We'd love to learn more about your interests and skills. If you indicate interest in joining a committee, your contact information will be given to the chairperson.
Please use Column 1 for Adult 1 and Column 2 for Adult 2 (if applicable).
ADULT 1 - I am interested in possibly joining these committees:
Adult Education Committee
Building Committee
Caring Committee
Cemetery Committee
Chevra Kadisha
Finance Committee
Forest School Committee
Green Team
New Member Committee
Ritual Practice Committee
Security Committee
Shorashim Religious School Committee
Social Action Committee
Tzedakah Fund Committee
ADULT 2 - I am interested in possibly joining these committees:
Adult Education Committee
Building Committee
Caring Committee
Cemetery Committee
Chevra Kadisha
Finance Committee
Forest School Committee
Green Team
New Member Committee
Ritual Practice Committee
Security Committee
Shorashim Religious School Committee
Social Action Committee
Tzedakah Fund Committee
ADULT 1 - I am interested in these programming areas and/or I have these skills to offer:
Adult Education
Building Maintenance/Repair
Gift Shop
Hadassah (We will give your contact info to the Charlottesville Chapter)
JewC Group (Young Adults)
Music - Choir or Band
Senior Connections
Social Action Projects
Teaching/Tutoring
Tikkun Middot/Mindfulness
Ushering
ADULT 2 - I am interested in these programming areas and/or I have these skills to offer:
Adult Education
Building Maintenance/Repair
Gift Shop
Hadassah (We will give your contact info to the Charlottesville chapter)
JewC Group (Young Adults)
Music - Choir or Band
Senior Connections
Social Action Projects
Teaching/Tutoring
Tikkun Middot/Mindfulness
Ushering
ADULT 1 - Please use this space if you would like to tell us more about your interests & skills.
ADULT 2 - Please use this space if you would like to tell us more about your interests & skills.
One way CBI helps congregants get connected is by including a short biography of new members in our weekly e-announcements. If you would like to be included in this, please use this space below to share your story (e.g. reason for moving to Charlottesville area, career, hometown, what you look forward to participating in at CBI...).
Biography (to be shared in e-news)
*
Would you prefer to be contacted by our Director of Communications to help write your bio?
Yes
No
I/we wish to participate in Congregation Beth Israel, making a personal and financial commitment to the support and continuation of this community.
*
Initial here to indicate your digital signature.
*
Date
After submitting this form, please go back to our Membership page and complete the Financial Support Commitment.
Please contact Raya at
office@cbicville.org
or 434-295-6382 if you have questions or need help with this process.
Be sure to click SUBMIT at the bottom when you have completed this form.
Mon, September 16 2024 13 Elul 5784
