Touro Synagogue Affiliate Application

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* Title

* First name

* Last name

Hebrew name - your name b. parent name(s)

Tribe

* Email address

* Address

* City

* State

* Zip code

* Home phone

* Cell phone

* Would you like Shearith Israel to send you nahala (yahrzeit) reminders?

Please Select OneYesNo

Click + for each memorial anniversary you would like to enter

* First name

* Last name

Hebrew name

* Gender

Please Select OneFemaleMale

English date of death

Before or after sunset?

BeforeAfter

Hebrew date of death

* Date of burial

Burial location

* Mourner name

* Relationship

Touro Synagogue Affiliation Dues: $36 annually, waived for members of Congregation Jeshuat Israel.

* Are you a dues-paying member of CJI?

Please Select OneYes (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) - $36Your first year's payments will cover membership through June 30, 2023.

* Is there another household member you'd like to include in your Touro Synagogue Affiliation?

Please Select OneYesNo

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

Email address

Cell phone

* Is this person under 21?

Please Select OneYesNo

* Date of birth

Total

Sun, November 27 2022 3 Kislev 5783

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