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New Member Application

Adult 1 Information

Adult 2 Information

General Information

Religious Background
Adult 1
Synagogue name
Adult 2
Synagogue name

Occupation and Community involvement
Adult 1
Adult 2

Child One
Child Two
Child Three
Child Four
Child Five

Friends and Family Affiliated with Shearith

Emergency Contact

Yahrtzeit Observance
Please provide the names and dates of death of loved ones for whom you would like to receive Yahrzeit notifications
Yahrtzeit One
as it should appear in the listings
Yahrtzeit Two
as it should appear in the listings
Yahrtzeit Three
as it should appear in the listings
Yahrtzeit Four
as it should appear in the listings
Yahrtzeit Five
as it should appear in the listings

Interests and Involvement
At Shearith Israel there are many ways to get involved! Please indicate your interests in one or more of the following areas by clicking the check boxes.

Congregation Shearith Israel Media Release

I hereby authorize Congregation Shearith Israel to use my photo and/or information  for the use of publications, including electronic publications, audiovisual presentations, promotional literature, advertising, community presentations, and media and/or other similar ways.

I further acknowledge that neither I nor any other party who may share ownership of the property described above (whether in the past or future), will receive financial compensation of any type associated with the taking or publication of these photographs or participation in Congregation Shearith Israel publications.  I acknowledge and agree that publication of said photos confers no rights of ownership or royalties whatsoever and that participation is voluntary.

I hereby release Congregation Shearith Israel, its contractors, its employees and any third parties involved in the creation or publication of marketing materials from liability for any claims by me or any third party in connection with my participation


How did you hear about Congregation Shearith Israel?
Can be individual photos or of you and your family

Membership Contribution

Membership at Shearith is an investment in the vibrant, warm and diverse community that we are building together.  From lower ticket prices for programs, to Rabbinic support for life cycle events, your membership not only supports programs, classes and initiatives, but also  makes them accessible to our members. Your spiritual growth and connection to a community is important to us. Below are a list of membership levels available to all members of our community. please select the dues level for you or your family.

Please keep in mind that all dues include High Holiday seating for Rosh Hashanah and Yom Kippur, except Associate Membership.

Please select a Benefactor level
Please select an age bracket
Please select an age bracket

Please write the name and location of the Synagogue with whom you have your other membership

Please enter the amount you will be contributing to dues for the year

If you selected Kehillah, your application is NOT complete until you have submitted your Kehillah application to the membership department at the JCC.
PLEASE NOTE: Once you've submitted your form, a staff member from our team will be in touch with you.
Sat, September 23 2023 8 Tishrei 5784