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Membership Form
Please verify reCaptcha before submitting the form.
Please fill in the following information as completely and accurately as possible. Contact
Susan Chayet, Membership Director
with any questions.
Note: If you receive an "Oops" error while attempting to submit this form, please do not submit again. Contact Susan, above. Our provider is working on the issue.
Adult Information
Adult 1
Contact Information
Title
*
First Name
Middle Name
*
Last Name
Suffix
Maiden Name
*
Preferred First Name
*
Email Address
*
Mobile Phone
*
Street Address
Street Address 2
*
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 Code
Employment Information
*
Occupation/Profession
Business/Employer Name
Business Phone
Additional Information
*
Date of Birth
*
Marital Status
Single
Married
Engaged
Divorced
Widowed
Separated
N/A
Partnered
Tell us about your secular education.
Photo - Show us your smile!
You can upload a maximum of 1 files.
Your Jewish Identity
Please tell us more about your Jewish identity. This information will not impact your membership. It just helps us get to know you better!
Hebrew Name
*
Current Religious Affiliation
Please Select One
Jewish
Not Jewish
*
In which religious tradition were you raised?
Please Select One
Reform Judaism
Conservative Judaism
Orthodox Judaism
Reconstructionist Judaism
Unaffiliated Judaism
Interfaith
Non-Jewish
*
In which religious tradition were you raised?
Please Select One
Reform Judaism
Conservative Judaism
Orthodox Judaism
Reconstructionist Judaism
Unaffiliated Judaism
Interfaith
Non-Jewish
*
Denomination/Describe
*
Did you convert to Judaism?
Please Select One
Yes
No
Interests
Learn more about our various interest groups.
Would you like to learn more about our interest groups?
Active/Retired Military
Adult Ski Group
Book Club
Chai Riders
Classical Music
Dog Lovers
Flick Friends
Hiking
Knitting
LGBTQIA+
Mitzvah Corps
Newcomer to Denver
Social Justice/Social Action
Vegetarian and Plant-Based Potluck Group
Wine Tasting
Brotherhood
Sisterhood
Do you have other hobbies, interests, or skills you would like to share?
Second Adult
*
Is there a second adult in the household to add to this form?
Please Select One
Yes
No
Adult 2
Contact Information
Title
*
First Name
Middle Name
*
Last Name
Suffix
Maiden Name
*
Preferred First Name
*
Email Address
*
Mobile Phone
Employment Information
*
Occupation/Profession
Business/Employer Name
Business Phone
Additional Information
*
Date of Birth
*
Marital Status
Single
Married
Engaged
Divorced
Widowed
Separated
N/A
Partnered
Tell us about your secular education.
Photo - Show us your smile!
You can upload a maximum of 1 files.
Your Jewish Identity
Please tell us more about your Jewish identity. This information will not impact your membership. It just helps us get to know you better!
Hebrew Name
*
Current Religious Affiliation
Please Select One
Jewish
Not Jewish
*
In which religious tradition were you raised?
Please Select One
Reform Judaism
Conservative Judaism
Orthodox Judaism
Reconstructionist Judaism
Unaffiliated Judaism
Interfaith
Non-Jewish
*
In which religious tradition were you raised?
Please Select One
Reform Judaism
Conservative Judaism
Orthodox Judaism
Reconstructionist Judaism
Unaffiliated Judaism
Interfaith
Non-Jewish
*
Denomination/Describe
*
Did you convert to Judaism?
Please Select One
Yes
No
Interests
Learn more about our various interest groups.
Would you like to learn more about our interest groups?
Active/Retired Military
Adult Ski Group
Book Club
Chai Riders
Classical Music
Dog Lovers
Flick Friends
Hiking
Knitting
LGBTQIA+
Mitzvah Corps
Newcomer to Denver
Social Justice/Social Action
Vegetarian and Plant-Based Potluck Group
Wine Tasting
Brotherhood
Sisterhood
Do you have other hobbies, interests, or skills you would like to share?
Child Information
*
How many children are there to add to this form?
Please Select One
Zero
One
Two
Three
If you have more than three children to add, please contact Susan Chayet, above.
Child 1
Basic Information
*
First Name
Middle Name
*
Last Name
Preferred First Name
*
Date of Birth
Child's Picture - Completely optional!
You can upload a maximum of 1 files.
Secular and Religious Education
*
Is this child currently enrolled in school?
Please Select One
Yes
No
*
Current Grade
Please Select One
Pre-School
K
1
2
3
4
5
6
7
8
9
10
11
12
College
*
Current School
*
Is this child being raised in the Jewish faith?
Please Select One
Yes
No
Interfaith
I am interested in this child attending the Rabbi Steven Foster Early Learning Center at Temple Emanuel.
I am interested in this child attending the Rabbi Steven Foster Early Learning Center at Temple Emanuel.
I am interested in this child attending religious school at Temple Emanuel.
I am interested in this child attending religious school at Temple Emanuel.
If this child has previously attended religious school, please list congregation and city.
Child 2
Basic Information
*
First Name
Middle Name
*
Last Name
Preferred First Name
*
Date of Birth
Child's Picture - Completely optional!
You can upload a maximum of 1 files.
Secular and Religious Education
*
Is this child currently enrolled in school?
Please Select One
Yes
No
*
Current Grade
Please Select One
Pre-School
K
1
2
3
4
5
6
7
8
9
10
11
12
College
*
Current School
*
Is this child being raised in the Jewish faith?
Please Select One
Yes
No
Interfaith
I am interested in this child attending the Rabbi Steven Foster Early Learning Center at Temple Emanuel.
I am interested in this child attending the Rabbi Steven Foster Early Learning Center at Temple Emanuel.
I am interested in this child attending religious school at Temple Emanuel.
I am interested in this child attending religious school at Temple Emanuel.
If this child has previously attended religious school, please list congregation and city.
Child 3
Basic Information
*
First Name
Middle Name
*
Last Name
Preferred First Name
*
Date of Birth
Child's Picture - Completely optional!
You can upload a maximum of 1 files.
Secular and Religious Education
Is this child currently enrolled in school?
Please Select One
Yes
No
*
Current Grade
Please Select One
Pre-School
K
1
2
3
4
5
6
7
8
9
10
11
12
College
*
Current Grade
*
Is this child being raised in the Jewish faith?
Please Select One
Yes
No
Interfaith
I am interested in this child attending the Rabbi Steven Foster Early Learning Center at Temple Emanuel.
I am interested in this child attending the Rabbi Steven Foster Early Learning Center at Temple Emanuel.
I am interested in this child attending religious school at Temple Emanuel.
I am interested in this child attending religious school at Temple Emanuel.
If this child has previously attended religious school, please list congregation and city.
Membership Dues
Please acknowledge the following and confirm the amount of your dues discussed with Temple staff.
*
I/We are aware that the Temple's fiscal year runs from July 1 through June 30.
I/We are aware that the Temple's fiscal year runs from July 1 through June 30.
*
I/We are aware that we can pay monthly, quarterly, semi-annually or annually.
I/We are aware that we can pay monthly, quarterly, semi-annually or annually.
*
I/We are aware we will be billed monthly and annually.
I/We are aware we will be billed monthly and annually.
*
Annual Membership Dues Level
Please Select One
Sustaining Level - $2,150
Identity Level - $2,750
Inspiration Level - $4,015
51 Grape Club - $5,850
Tzedek Circle - $11,500
Pearl Society - $25,000
Other:
Other Dues Amount
Enter a number without the $.
Capital Improvement Fund
All new members are asked to make a pledge to the Capital Improvement Fund of Temple Emanuel to maintain our beautiful facility and plan for future needs. The recommended pledge is twice the amount of your annual commitment. Members under the age of 31 are to determine this pledge upon reaching the age of 31.
This pledge is payable over five years and, unless otherwise indicated, charges begin the second year of membership.
*
I/We pledge the following amount to the Capital Improvement Fund of Temple Emanuel:
Enter a number without the $.
Mon, October 14 2024 12 Tishrei 5785
