BNAI JACOB SHAAREI ZION CONGREGATION
6602 Park Heights Avenue, Baltimore, MD 21215

Membership Information Form

Please complete this information form and submit to enable the office and the Gabboim to best serve you. Please include information for all family members as applicable. If preferred, you may download the print version of this form and fax it to the Shul office: 410-358-2631.
Date:  
Correspondence Information
Name(s), including titles(s):
Address:
City:
State:
Zip Code:
Home Telephone:
Business Telephone:
E-Mail:    
Family Information:      
Please list legal names and dates of birth of all family members residing at home:
           
Membership Fee: (July thru June)
Family:
 $625
$425 Young Member Discount (either member of couple under 35)
$325 Young Member Discount (either member of couple under 30)
Single:
 $425
Seniors:
 $580
Associate membership:
 $250
  (No fees will be processed now.)
Aliyah Information:
Kohen
 Levi Yisroel    
Hebrew Name:
Bar Mitzvah Parsha:
Please list complete Hebrew names of all living relatives you would like the Gabbaim to mention in "Mi Shebeirach" when you are called to the Torah:
           
Yahrzeit Information:
English Name: Hebrew Name:
Hebrew Date: Relationship:
English Name: Hebrew Name:
Hebrew Date: Relationship: