New Membership Application - Form - Congregation B'nai Israel

We exist to make life's Jewish journey more meaningful together.

Family is at the core of our congregation. CBI is family - loving, supportive and available for guidance. CBI is the place where we share a bagel, a story and a shoulder to lean on when we are in need. When we come together as a community and find ways to celebrate together, have fun together, mourn together, learn together, volunteer together and pray together then we become a Kehillah Kedosha, a holy community.

We welcome your application for membership. Please fill out the form below so we can get to know you better!

*NCECE Preschool Inquiries: Please note-There are currently very limited spots available. Please contact Rebeca Rosenblatt at ext. 212 for further information.**

* Are you a CBI staff member?

* Please select from the list below:

Address Information

* Address

* City

* State

* ZIP

Do you have a seasonal address?

Seasonal Address Information

* Seasonal - Address

* Seasonal - City

* Seasonal - State

* Seasonal - ZIP

Adult 1 Information

* Adult 1 - Title

* Adult 1 - First Name

Adult 1 - Middle Name

* Adult 1 - Last Name

* Adult 1 - Gender

* Adult 1 - Date of Birth

* Adult 1 - Email Address

* Adult 1 - Mobile Phone

Adult 1 - Hebrew Name

Adult 1 - Would you like to be an organ donor?

Adult 1 - Religious Background

* Adult 1 - Marital Status

Adult 1 - Anniversary Date, if applicable

* Adult 1 - Emergency Contact Name

* Adult 2 - Emergency Contact Name

Adult 1 Interests

What activities/groups would you like to be involved in (check all that apply)?

Monthly Blanket MakingWeekly Sandwich AssemblyMitzvah ProjectsSocial Action

PreschoolReligious schoolYouth Groups

Adult 1 Business Information

Adult 1 - Organization Name

Adult 1 - Industry

Adult 1 - Occupation

Adult 1 - Business Email

Adult 1 - Business Address

Adult 1 - Business City

Adult 1 - Business State

Adult 1 - Business ZIP

Is there a second Adult applying for membership?

Adult 2 Information

* Adult 2 - Title

* Adult 2 - First Name

Adult 2 - Middle Name

* Adult 2 - Last Name

* Adult 2 - Gender

* Adult 2 - Date of Birth

* Adult 2 - Email Address

* Adult 2 - Mobile Phone

Adult 2 - Hebrew Name

Adult 2 - Would you like to be an organ donor?

Adult 2 - Religious Background

* Adult 2 - Emergency Contact Name

* Adult 2 - Emergency Contact Phone

Adult 2 Interests

What activities/groups would you like to be involved in (check all that apply)?

Adult Education and ProgramsYouth Engagement ProgramsEarly Learning Center (infant care, preschool, summer camp)20s and 30s, singles and couplesBrotherhoodIsrael (events and programs)

Adult 2 Business Information

Adult 2 - Organization Name

Adult 2 - Industry

Adult 2 - Occupation

Adult 2 - Business Email

Adult 2 - Business Address

Adult 2 - Business City

Adult 2 - Business State

Adult 2 - Business ZIP

Child Information

Please click the + button below to add each child living at home.

* First Name

* Last Name

Nickname

* Gender

* Date of Birth

Hebrew Name

* Name of School

* Public/Private School Grade

Mobile Phone, if applicable

* Family emergency contact

* Relationship

* Emergency contact Phone

Yahrzeit Information

Please click the + button below to add each yahrzeit you wish to observe.

* Name of Deceased

* English Date of Death

* Do you prefer Hebrew or English observance?

* Relationship

* To whom?

Why are you joining CBI?

Please choose your options below.

Pre-SchoolReligious SchoolFamily ProgrammingSocial Groups

Friends & Family that Attend CBI:

Member Name and Relationship

Current Involvements

How did you hear about CBI?

Cemetery Arrangements

Pre-need Arrangements

Name and location of funeral home

Name and location of cemetery

Previous Congregational Affiliation

Name and location of congregation

Current/prior organization involvement and/or volunteer positions held

Payment Information

For your convenience, Congregation B'nai Israel offers multiple options for paying your membership dues. You can pay in full, quarterly or monthly via credit card, debit card, check or bank auto draft. The monthly option is only available with recurring credit card, debit card or auto draft). A one-time 2.98% processing fee of your total bill will be added to your first payment for any option other than pay in full. Once this application has been processed, someone from Membership will contact you to finalize your payment.