Membership - High Holiday Seats

Due to Security concerns reservations & membership is required to attend service.
Membership starts at $1 a month.

No one will be turned away due to lack of funds. If you know anyone that cannot afford seats, please email [email protected]
Membership - High Holiday Seats
Men's Seat $100
Women's seat $100
Number of Children in kids Program $72
An annual membership form must be filled out for security clearance into our shul for the High Holidays. You can skip any information that you have filled out in previous years.
Full Name*

First Name Last Name
Hebrew Name
Birth Date

Month Day Year
E-mail*
Occupation
Jewishness

From BirthConvertNot Jewish
Family

KohenLeviYisroel
Cell Number

Area Code Phone Number
Work Number

Area Code Phone Number
Home Number

Area Code Phone Number
Spouse Full Name

First Name Last Name
Hebrew Name
Jewishness

From BirthConvertNot Jewish
Family

KohenLeviYisroel
Occupation
Cell Number

Area Code Phone Number
Work Number

Area Code Phone Number
Home Number

Area Code Phone Number
Birth Date

Month Day Year
E-mail

Address

Marital Status
Anniversary Date

Month Day Year
Previous Synagogue & Rabbi
CHILDREN
Full Name

First Name Last Name
Birth Date

Month Day Year
Full Name

First Name Last Name
Birth Date

Month Day Year
Full Name

First Name Last Name
Birth Date

Month Day Year
Full Name

First Name Last Name
Birth Date

Month Day Year
Yahrtzeits
Full English Name

First Name Last Name
Hebrew Name Hebrew name ben/bas Parents Hebrew name
Date of Passing

Month Day Year
Time of Passing
Full English Name

First Name Last Name
Hebrew Name Hebrew name ben/bas Parents Hebrew name
Date of Passing

Month Day Year
Time of Passing
Additional Information
Membership Plan

Please choose your monthly membership option.
Choose 1*

Please continue to charge my monthly donation from last yearCommunity Member $1-$99 monthly ( $12 - $1188 annually)Community Supporter $100 - $359 monthly ($1200 - $4308 annually)Community Builder $360 - $539 monthly ($4320-$6468 annually)Community Pillar $540 & above monthly ($6480 & above annually)
Please Charge my card Monthly

$
Please charge my card a one time donation

$
Total

$0.00

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