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TEMPLE BETH ISRAEL Longboat Key, Florida

This application is for the use of Florida non-residents who spend no more than four months per year in the area. To be eligible for membership, the Winter Residents (non-resident) must show a valid license from their home state. Membership will be renewed each year upon showing a valid out-of-state license. This non-resident membership includes all privileges of membership except High Holy Day tickets. Upon becoming a Florida resident, the member must assume the full dues and Capital Fund obligations then in effect.

Date_________________      Family: $750.00 annually Single: $425.00 annually

Last Name ________________________________

Name (first)______________________ (middle)_________________________ Email___________________________

Spouse (first)_____________________ (middle)_________________________Email___________________________

Local Address___________________________________  Apt#___________

City ___________________________________State_____ Zip_____________

Home phone ___________________________Fax______________________
Northern Address
Northern Phone_________________________Fax______________________

Date of birth
(male) __________________________(female)____________________________

Marital status
(Married) Single Anniversary Date_____________________________________

Current Occupation
(Male)________________________________ (Female) ___________________________________

Former Occupation
(Male)________________________________(Female)_____________________________________

Religious Tradition in Which You Were Raised:
Reform     Conservative     Orthodox     Secular     Jew-by-Choice     Non-Jewish     Other

Male: ___________________________________Female___________________________________
Children or Nearest Relative (Use back of sheet if more space is needed)
Name                                             Age                 Address                                                                     Phone                     Fax/Email

____________________________________________________________________________________________________

____________________________________________________________________________________________________
 
 

In Case of Emergency, please notify:__________________________________________________________________
 

COMMITTEE OPPORTUNITIES

Please check each committee on which you would like to participate:
 

___ Continuing Education	___ Beth Israel Women	___ Caring
___ Ritual	___ Men’s Club	___ Art
___ Bulletin	___ Women On Our Own	___ Outreach
___ Communications	___ Social Action	___ Finance / Budget
___ Library	___ Community Relations	___ Cemetery
___ Music / Choir
___ Other __________________	______________________________

Are you willing to participate in our Worship Services?         Male ____Yes       Female ____Yes
(Reading of Hebrew not required)
 

Yahrzeit Information:

(Reminders will be sent to you, remembered at the appropriate Friday night Shabbat Service and published in the Temple Bulletin)
 
 

Name	Relationship	Date of Death (English)
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Last updated on March 6, 2009