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Touro Synagogue Affiliate Application
Please verify reCaptcha before submitting the form.
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Title
*
First name
*
Last name
Hebrew name - your name b. parent name(s)
Tribe
Cohen
Levi
Israel
None Set
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Email address
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Address
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City
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State
--Select State--
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District of Columbia
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Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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Zip code
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Home phone
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Cell phone
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Would you like Shearith Israel to send you nahala (yahrzeit) reminders?
Please Select One
Yes
No
Click + for each memorial anniversary you would like to enter
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First name
*
Last name
Hebrew name
*
Gender
Please Select One
Female
Male
English date of death
Before or after sunset?
Before
After
Hebrew date of death
*
Date of burial
Burial location
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Mourner name
*
Relationship
Touro Synagogue Affiliation Dues: $36 annually, waived for members of Congregation Jeshuat Israel.
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Are you a dues-paying member of CJI?
Please Select One
Yes (your Touro Synagogue Affiliate Membership dues are waived)
No, but I am Jewish and attend services (or other events) at the the Touro Synagogue from time to time.
Your Touro Synagogue Affiliate dues are waived.
Annual dues (July 1-June 30) - $36
Your first year's payments will cover membership through June 30, 2023.
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Is there another household member you'd like to include in your Touro Synagogue Affiliation?
Please Select One
Yes
No
Click + for each person you would like to include
*
Relationship to you
*
Title
*
First name
*
Last name
Hebrew name - person's name b. parent name(s)
Tribe
None set
Cohen
Levi
Israel
Email address
Cell phone
*
Is this person under 21?
Please Select One
Yes
No
*
Date of birth
Total
Sun, October 13 2024 11 Tishri 5785