5784 Young Family Membership Application

Young Family Membership Application

My Information

* First Name

* Last Name

Hebrew Name

* Date of Birth

* Address

* City

* State

* Zip

* Home Phone #

* Cell Phone #

* Email Address

* Are you Jewish?

Mother's Hebrew Name

Father's Hebrew Name

Tribe (if not known type N/A)

Occupation

Work Phone #

Can you read Hebrew?

My Spouse/Partner

First Name

Last Name

Hebrew Name

Date of Birth

Address

If same: please leave blank

City

State

Zip

Home Phone #

Cell Phone #

Email Address

Are you Jewish?

Mother's Hebrew Name

Father's Hebrew Name

Tribe (if not known type N/A)

Occupation

Work Phone #

Can you read Hebrew?

Number of Children

Child #1 Information

First Name

Gender

* Date of Birth

Child's Hebrew Name

Name of School

Grade

Child # 2 Information

First Name

Gender

* Date of Birth

Child's Hebrew Name

Name of School

Grade

Child # 3 Information

First Name

Gender

* Date of Birth

Child's Hebrew Name

Name of School

Grade

Child # 4 Information

First Name

Gender

* Date of Birth

Child's Hebrew Name

Name of School

Grade

Please answer a few questions below, we would love to get to know you!

Thank you for joining! What made you decide to join our WJC family?

If you have any relatives that are currently members of the WJC, please list names and relationships:

How did you hear about WJC?

What are you looking for in being a member of the WJC family?

Is there anything you would like us to know about you/your family?

* WE WOULD LIKE TO JOIN WJC AT THE YOUNG FAMILY MEMBERSHIP LEVEL

WE WOULD LIKE TO JOIN WJC AT THE YOUNG FAMILY MEMBERSHIP LEVELThis membership is for the Jewish Year of 5784 (2023-2024)

TOTAL

Tue, September 26 2023 11 Tishrei 5784