Membership - Shaare Zedek Congregation

WELCOME!

We hereby apply for membership at Shaare Zedek Congregation, Montreal, Quebec, Canada. If accepted, we agree to abide by and conform to its Constitution and by-laws now existing or which may be enacted from time to time. We undertake to make payment in accordance with the present regulations or those which may be adopted in the future.

Adults on Account

ADULT 1 INFORMATION

ENGLISH NAME

Adult 1 Title

* First

Middle

* Last

Suffix

HEBREW NAME

Hebrew First

Father's Hebrew

Mother's Hebrew

WORK DETAILS

Work Status

Employer

Position

Phone

Former Employer

Former Position

School Name

BAR/BAT MITZVAH DETAILS

Bar/Bat Mitzvah Date

Location

Parsha

OTHER DETAILS

* Email

Mobile Phone

Birthdate

Gender

ADULT 2 INFORMATION

ENGLISH NAME

Adult 2 Title

First

Middle

Last

Suffix

HEBREW NAME

Hebrew First

Father's Hebrew

Mother's Hebrew

WORK DETAILS

Work Status

Employer

Position

Phone

Former Employer

Former Position

School Name

BAR/BAT MITZVAH DETAILS

Bar/Bat Mitzvah Date

Location

Parsha

OTHER DETAILS

Mobile Phone

Birthdate

Gender

ADDRESS INFORMATION

PRIMARY ADDRESS

Address Line 1

Address Line 2

City

State/Province

Postal Code

Home Phone

ADDITIONAL ADDRESSES

Enter other address?

How many addresses?

Address Description

e.g. winter home, summer home

Mailing Address When?

e.g. Usually January - March

Address Line 1

Address Line 2

City

Province

Postal Code

Address Phone

OTHER ACCOUNT DETAILS

Preferred Billing Method

Marital Status

Wedding Anniversary

Name of Rabbi who performed marriage ceremony

Of which congregation

City

Minyan

Tribe

OTHER HOUSEHOLD MEMBERS

Enter other household members?

How many household members?

ENGLISH NAME

First

Middle

Last

HEBREW NAME

First

Father's

Mother's

OTHER DETAILS

Mobile

Relationship to adults(s) above

Birthday

Gender

Notes

Enter any additional information you wish to share about this person.

The following is necessary for processing your application for membership. This information will be held in strict confidence. Please feel free to call on the Rabbi to assist you.

Adult 1

Jewish by birthAdoptedJewish by choice

If so, conversion performed by Rabbi or Beit Din

Conversion Date

City

Adult 2

Jewish by birthAdoptedJewish by choice

If so, conversion performed by Rabbi or Beit Din

Conversion Date

City

Please upload your conversion certificate if you have one.

YAHRZEITS

Enter yahrzeits?

How many yahrzeits?

DECEASED DETAILS

Deceased First Name

Last Name

Hebrew Name

Gender

PASSING INFORMATION

Date of Death (English)

Date of Death (Hebrew)

After Sunset

NoYes

BURIAL INFORMATION

Date of Burial (English)

Burial Location

MOURNER INFORMATION

Enter below up to four mourners for the deceased. If you need to add additional mourners, please include that in the Notes field at the end of this section.

Relationship 1

Father, mother, etc. of mourner

Mourner Name 1

Person in your household above

Is Chiyuv 1

Relationship 2

Father, mother, etc. of mourner

Mourner Name 2

Person in your household above

Is Chiyuv 2

Relationship 3

Father, mother, etc. of mourner

Mourner Name 3

Person in your household above

Is Chiyuv 3

Relationship 4

Father, mother, etc. of mourner

Mourner Name 4

Person in your household above

Is Chiyuv 4

Yahrzeit Notes

Enter any notes about any of the above yahrzeits including leap year custom followed (Adar I and Adar II) and any additional mourners, if applicable, and relations.