Questions about this form? Contact Membership Coordinator, Ariana Shane and she will be happy to help!
310-652-7354 ext 223 or ashane@tbala.org

Adult Household Members

Member 1

Last Namerequired

First Name(s) of Adult Member(s)required

Middle name

Nickname (if preferred)

Title

Hebrew Name

ie: Moshe ben David v'Sara

Tribe

Kohen Levi Israel

M/F

M F

Date of Birthrequired

Occupationrequired

Type of Business

Job Title

Work Phone

Work Address

Home Phonerequired

Cell Phonerequired

Emailrequired

Religious Background

Born to Jewish:*

Mother Father Both Neither

Previous or Other Congregational Affiliations

Names, Location, Dates

Congregations growing up

Include Name, Location, and Affiliation (Conservative, Orthodox, Reform, etc.)

Converted to Judaismrequired

Date (or approximate date), Location, Sponsoring Rabbi

Have you been active in Temple life?

Yes No

If yes, in what capacity?

Member 2

Last Name

First Name(s) of Adult Member(s)

Middle name

Nickname (if preferred)

Title

Hebrew Name

ie: Moshe ben David v'Sara

Tribe

Kohen Levi Israel

M/F

M F

Date of Birth

Occupation

Type of Business

Job Title

Work Phone

Work Address

Home Phone

Cell Phone

Email

Religious Background

Born to Jewish:

Mother Father Both Neither

Previous or Other Congregational Affiliations

Names, Location, Dates

Congregations growing up

Include Name, Location, and Affiliation (Conservative, Orthodox, Reform, etc.)

Converted to Judaism

Date, Location, Sponsoring Rabbi

Have you been active in Temple life?

Yes No

If yes, in what capacity?

Home Contact Information

Address 1required

Address 2

Cityrequired

Staterequired

Ziprequired

Home Phone

Home Fax

Other, please describe

Anniversary Date (mm/dd/yyyy)

Children

List Children

Please provide children's full name(s), sex, birth date, Hebrew name, and School

Adult Children

Please list your adult children's names, spouse (if any), Birth date, Address, and Email

Relatives who are members of Temple Beth Am

Please list names and relationships

List of Departed for Yahrzeit Notification

Please list name of deceased - English and Hebrew names, Date of Death (mo/dd/yy), Before or After Sundown, and Relationship

Membership Types

All member contact information (including cell phones) is published in our Membership Directory.

I do NOT want my contact information in the TBA Membership Directory

Please select ONE of the following Membership Categories:

Basic

Includes High Holiday tickets in the Service of your choice. 1 ticket for One-Member Household, 2 tickets for Two-Member Household.

Two-Adult Household ($3965) One-Adult Household ($1985)

Young Adults

Under age 35; no JLC or Day School privileges.

Two-Adult Household ($1985) One-Adult Household ($995)

Students & Under 26

No JLC or Day School privileges.

Two-Adult Household ($412) Individual Student Membership ($206)

Annual Giving/Jeremiah Society

Join a visionary group of Temple Beth Am and Pressman families whose generosity makes our community strong!

Yes!

Community Kihilla $1-$999
Friends Haverim $1,000-$1,799
Head's Circle/Angel $1,800-$3,599
Prophets Neviim $3,600-$7,999
Supporters Tomkhim $8,000-$17,999
Builders Bonim $18,000-$24,999
Benefactors Tzadikkim $25,000-$35,999
Heroes Giborim $36,000-$49,999
Guardians Shomrim $50,000-$99,999
Pillars Amudim $100,000 +

Enter your Jeremiah/Annual Giving Amount

Please select ONE of the following participation options:

Participation Options:*

Please select your payment preference. Please note that if you select the 50% option, the balance must be paid by December 31, 2020.

Full 50% Payment Plan (by Check) Payment Plan (by Credit Card)

Enter your name and phone numberrequired

Please provide your name and best phone number to reach you. Victor Krymer in accounting will contact you for additional information needed to process payment plans. Thank you.

Membership Duesrequired

Please indicate the portion of your dues you would like to pay now.

Additional Fees & Participation

Facility Fee*

*** Half of the funds from the Facility Fee are held in a special account for emergency facility related expenses; the balance supports growing needs to maintain our facility on an ongoing basis.

$200

Security Fee*

Family ($700) Individual ($350)

Additional Fees & Participation

Facility Fee*

*** Half of the funds from the Facility Fee are held in a special account for emergency facility related expenses; the balance supports growing needs to maintain our facility on an ongoing basis.

$200

Security Fee*

Family ($700) Individual ($350)

Additional Fees & Participation

Facility Fee*

*** Half of the funds from the Facility Fee are held in a special account for emergency facility related expenses; the balance supports growing needs to maintain our facility on an ongoing basis.

$200

Security Fee*

Family ($700) Individual ($350)

TBA Sisterhood Membership

Sisterhood Member ($50)

Total Amount Due:

Opportunities for Involvement at Temple Beth Am

Hesed Committee

Helps members whose circumstances evoke a need for acts of loving kindness

Drive an elderly member to Services Prepare a meal for a family during Shiva Visiting the sick Host TBA members/visitors for a Shabbat meal

Membership Committee

Deliver Welcome Baskets to New Members Serve as a "buddy" family/individual for a new member Serve as a Greeter on Shabbat or Holidays Make outreach phone calls to prospective or returning TBA members

Resource Development (Fundraising) House & Grounds Committee Sisterhood Men's Society

Pressman Parent Association

Day School ECC JLC (Religious School)

Volunteer in the Gift Shop Volunteer in the Temple office (for special mailings and other projects during business hours) Volunteer in the Lainer Library Young Adults @Beth Am (YABA) for ages 20-39 Jewlyweds (for newly married and engaged couples) Opportunities for Adult Learning Tikkun Olam - Social Action/Community Service

I would like to see the following program(s) offered at TBA:

If you'd like to be involved but you're not sure how, please don't hesitate to contact Lia Mandelbaum, our Director of Programming & Engagement at 310-652-7354 ext 215

Questions about this form? Contact Membership Coordinator, Ariana Shane and she will be happy to help!310-652-7354 ext 223 or ashane@tbala.org

Adult Household Members

Member 1

Religious Background

Member 2

Religious Background

Home Contact Information

Children

Membership Types

Please select ONE of the following Membership Categories:

Please select ONE of the following participation options:

Additional Fees & Participation

Additional Fees & Participation

Additional Fees & Participation

Opportunities for Involvement at Temple Beth Am

If you'd like to be involved but you're not sure how, please don't hesitate to contact Lia Mandelbaum, our Director of Programming & Engagement at 310-652-7354 ext 215

Questions about this form? Contact Membership Coordinator, Ariana Shane and she will be happy to help!
310-652-7354 ext 223 or ashane@tbala.org