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WJC First Responder Complimentary Membership Offer
WJC First Responder New Membership Application 2020-2021
*
Membership type
Please Select
Single
Senior Single (65+)
Senior Couple (65+)
L'Dor V'Dor (Couples without children in our Religious School)
Junior Family (For couples with children under 3rd grade)
Family (For couples with at least one child enrolled in our Religious School grades 3-7)
School Family (Four couples with children in our preschool only)
Non-Resident (couple)
Primary #1
*
First Name
*
Last Name
Hebrew Name
*
Date of Birth
Address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
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Maine
Maryland
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Michigan
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Mississippi
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New York
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Ohio
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Puerto Rico
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South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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
Business Phone #
*
Can you read Hebrew?
Primary #2
*
First Name
*
Last Name
Hebrew Name
*
Date of Birth
Address
City
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
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
Business Phone #
Can you read Hebrew?
Number of Children
Please Select
I do not have children
ONE
TWO
THREE
FOUR
*If child was adopted and birth mother was not Jewish, or if either spouse converted to Judaism, please provide conversion documents.
Child #1 Information
First Name
Gender
N/A or Unknown
Male
Female
Date of Birth
Child's Hebrew Name
*
Name of School
*
Grade
Child # 2 Information
First Name
Gender
N/A or Unknown
Male
Female
Date of Birth
Child's Hebrew Name
Name of School
Grade
Child # 3 Information
First Name
Gender
N/A or Unknown
Male
Female
Date of Birth
Child's Hebrew Name
Name of School
Grade
Child # 4 Information
First Name
Gender
N/A or Unknown
Male
Female
Date of Birth
Child's Hebrew Name
Name of School
Grade
If you have any relatives that are currently members of the Woodbury Jewish Center please list name and relationship
Please note that once your account is set up, you will receive an email to set up a password and you will be able to add any Yahrzeits to your account.
Sat, July 5 2025 9 Tammuz 5785